MEDICARE: JOHN THOMAS CAPUANO JR. DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC008010L	PA

General Provider Information

NPI Number	:	1710971973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN THOMAS CAPUANO JR. DC

Provider Business Mailing Address
First Line	:	10680 ROUTE 30
Second Line	:
City	:	N HUNTINGDON
State	:	PA
Zip	:	15642-2048
Country	:	US
Telephone Number	:	724-861-9455
Fax Number	:	724-861-9456

Provider Business Practice Location Address
First Line	:	10680 ROUTE 30
Second Line	:
City	:	N HUNTINGDON
State	:	PA
Zip	:	15642-2048
Country	:	US
Telephone Number	:	724-861-9455
Fax Number	:	724-861-9456

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2005
Last Update Date	:	10/04/2011

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