Provider Demographics
NPI:1265568836
Name:ROJAS, LUIS DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:DAVID
Last Name:ROJAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 SHIRLEY AVE
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:GA
Mailing Address - Zip Code:31533-2325
Mailing Address - Country:US
Mailing Address - Phone:912-384-4494
Mailing Address - Fax:912-393-3381
Practice Address - Street 1:105 SHIRLEY AVE
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:GA
Practice Address - Zip Code:31533-2325
Practice Address - Country:US
Practice Address - Phone:912-384-4494
Practice Address - Fax:912-393-3381
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008159111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor