Provider Demographics
NPI:1699243444
Name:CAPOFERRI, DAVID A
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:CAPOFERRI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6316 SPALDING DR STE 1
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-4668
Mailing Address - Country:US
Mailing Address - Phone:770-448-4742
Mailing Address - Fax:770-448-4730
Practice Address - Street 1:6316 SPALDING DR STE 1
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-4668
Practice Address - Country:US
Practice Address - Phone:770-448-4742
Practice Address - Fax:770-448-4730
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-09
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA1786111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty