Individual
JOHN ALFRED LUPO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
3901 LIBERTY ST, ERIE, PA 16509-1689
(814) 866-5559
Mailing address
3901 LIBERTY ST, ERIE, PA 16509-1689
(814) 866-5559
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC005039L
PA
247200000X
Other Technician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019387450001
—
PA
01
—
LU133922
PTAN
PA
Enumeration date
10/04/2006
Last updated
08/10/2012
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