Provider Demographics
NPI:1104217710
Name:DAVIES, LORI (DC)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:DAVIES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E 14TH ST
Mailing Address - Street 2:STE A
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14903-1339
Mailing Address - Country:US
Mailing Address - Phone:607-735-2125
Mailing Address - Fax:607-735-2126
Practice Address - Street 1:200 E 14TH ST
Practice Address - Street 2:STE A
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14903-1339
Practice Address - Country:US
Practice Address - Phone:607-735-2125
Practice Address - Fax:607-735-2126
Is Sole Proprietor?:No
Enumeration Date:2015-02-18
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH962111N00000X
NYX012516-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor