Lorraine Provenzano, Chiropractic, INC.
Chiropractor in Indio, CA. Organization (NPI-2).
NPI number1710071824
StatusActive
Last updated in NPPESMay 29, 2008
Details
- NPI
- 1710071824
- Entity type
- Organization (NPI-2)
- Legal business name
- Lorraine Provenzano, Chiropractic, INC.
- Organization subpart
- No
- Enumeration date
- Oct 3, 2006
- Last updated
- May 29, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | 16144 | CA | Yes |
Practice location
81709 Doctor Carreon Blvd Ste A5Indio, CA 92201-5509
Phone 760-342-2264 · Fax 760-342-4370
Mailing address
81709 Doctor Carreon Blvd Ste A5Indio, CA 92201-5509
Phone 760-342-2264 · Fax 760-342-4370
Authorized official
Lorraine Ann Provenzano
Owner/ President
7603422264
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