Provider Demographics
NPI:1154595361
Name:MUELLER, LORI L (DAOM, LAC, MBA)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:L
Last Name:MUELLER
Suffix:
Gender:F
Credentials:DAOM, LAC, MBA
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:L
Other - Last Name:GRITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DAOM, LAC, MBA
Mailing Address - Street 1:1670 KETTNER BLVD
Mailing Address - Street 2:APT 507
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-2560
Mailing Address - Country:US
Mailing Address - Phone:619-829-4418
Mailing Address - Fax:619-421-0434
Practice Address - Street 1:1670 KETTNER BLVD
Practice Address - Street 2:APT 507
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-2560
Practice Address - Country:US
Practice Address - Phone:619-829-4418
Practice Address - Fax:619-421-0434
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8930171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist