Provider Demographics
NPI:1013188184
Name:WALFOORT, LORA (DC)
Entity Type:Individual
Prefix:DR
First Name:LORA
Middle Name:
Last Name:WALFOORT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:CONTRERAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1021 N MARKET PLZ STE 102
Mailing Address - Street 2:
Mailing Address - City:PUEBLO WEST
Mailing Address - State:CO
Mailing Address - Zip Code:81007-1532
Mailing Address - Country:US
Mailing Address - Phone:719-547-0237
Mailing Address - Fax:
Practice Address - Street 1:1021 N MARKET PLZ STE 102
Practice Address - Street 2:
Practice Address - City:PUEBLO WEST
Practice Address - State:CO
Practice Address - Zip Code:81007
Practice Address - Country:US
Practice Address - Phone:719-547-0237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-17
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7909111N00000X
COCHR0008027111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor