Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | IL |
NPI | 1114143625 |
---|---|
Provider Name | David Luyando JR. |
First Address | Chicago, IL 60617-7314 |
Second Address | Chicago, IL 60617-7314 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 08/07/2007 |