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Organization

LASCALA CHIROPRACTIC, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DAVID A. LASCALA D.C. (OWNER)
(770) 922-0770
Entity
Organization

Contact information

Practice address
1226 ROYAL DR SW, CONYERS, GA 30094-5966
(770) 922-0770
(770) 922-0777
Mailing address
PO BOX 82510, CONYERS, GA 30013-9437
(770) 922-0770
(770) 922-0777

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5336
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
511G701256
MEDICARE PTAN
GA
Enumeration date
09/30/2008
Last updated
11/14/2012
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