Organization
COLONIAL CHIROPRACTIC, LLC
Active
Other names
Colonial Wellness & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY T YACUCCI D.C. (OWNER)
(302) 328-1444
Entity
Organization
Contact information
Practice address
105 PENN MART SHOPPING CTR, NEW CASTLE, DE 19720-4208
(302) 328-1444
(302) 328-1952
Mailing address
105 PENN MART SHOPPING CTR, NEW CASTLE, DE 19720-4208
(302) 328-1444
(302) 328-1952
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
FL0000438
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
490056
MEDICARE ID - TYPE UNSPECIFIED
—
Enumeration date
01/07/2015
Last updated
01/07/2015
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