Provider Demographics
NPI:1073858536
Name:DAVIS, LAUREN RACHEL (DC)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:RACHEL
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6106 KESTRELPARK DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-4840
Mailing Address - Country:US
Mailing Address - Phone:813-657-0445
Mailing Address - Fax:
Practice Address - Street 1:3601 BELL SHOALS RD
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-6199
Practice Address - Country:US
Practice Address - Phone:813-654-3921
Practice Address - Fax:813-684-2758
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7364111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor