Provider Demographics
NPI:1699747725
Name:HAMILTON, LORI LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:LYNN
Last Name:HAMILTON
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4165 BLACKHAWK PLAZA CIR
Mailing Address - Street 2:SUITE #250
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94506-4904
Mailing Address - Country:US
Mailing Address - Phone:925-736-2663
Mailing Address - Fax:925-736-0246
Practice Address - Street 1:4165 BLACKHAWK PLAZA CIR
Practice Address - Street 2:SUITE #250
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94506-4904
Practice Address - Country:US
Practice Address - Phone:925-736-2663
Practice Address - Fax:925-736-0246
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-02
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 20991111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0209910Medicare ID - Type UnspecifiedMEDICARE ID #