MEDICARE: DR. LOUIS J CAVALLO 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	38MC00518000	NJ
2	111N00000X	Chiropractor	5821	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	C805580	OTHER	CO	MEDICAREPTAN
8	P00236812	OTHER	NJ	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	621921	OTHER	NJ	UNTIED HC
3	P833467	OTHER	NJ	OXFORD
4	2230355	OTHER	NJ	AETNA
5	1K0384	OTHER	NJ	HEALTHNET
6	2422986000	OTHER	NJ	AMERIHEALTH/BLUE CROSS
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841262920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUIS J CAVALLO DC

Provider Business Mailing Address
First Line	:	1503 MOUNTAIN VIEW AVE
Second Line	:
City	:	LONGMONT
State	:	CO
Zip	:	80501
Country	:	US
Telephone Number	:	303-678-8555
Fax Number	:	303-678-2931

Provider Business Practice Location Address
First Line	:	1503 MOUNTAIN VIEW AVE
Second Line	:
City	:	LONGMONT
State	:	CO
Zip	:	80501-3201
Country	:	US
Telephone Number	:	303-678-8555
Fax Number	:	303-678-2931

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

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	03/02/2017

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Directions to “ DR. LOUIS J CAVALLO DC” Practice Location

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