Provider Demographics
NPI:1538200795
Name:LAWHORN CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:LAWHORN CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWHORN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:916-481-9961
Mailing Address - Street 1:3575 ARDEN WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864-2911
Mailing Address - Country:US
Mailing Address - Phone:916-481-9961
Mailing Address - Fax:916-481-9962
Practice Address - Street 1:3575 ARDEN WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95864-2911
Practice Address - Country:US
Practice Address - Phone:916-481-9961
Practice Address - Fax:916-481-9962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-25738111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0257380Medicare ID - Type Unspecified