Provider Demographics
NPI:1154657237
Name:KAREN LORD DC PA
Entity Type:Organization
Organization Name:KAREN LORD DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:LORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:352-793-3322
Mailing Address - Street 1:483 E C 48
Mailing Address - Street 2:
Mailing Address - City:BUSHNELL
Mailing Address - State:FL
Mailing Address - Zip Code:33513-8331
Mailing Address - Country:US
Mailing Address - Phone:352-793-3322
Mailing Address - Fax:352-569-5820
Practice Address - Street 1:1122 W C 48
Practice Address - Street 2:
Practice Address - City:BUSHNELL
Practice Address - State:FL
Practice Address - Zip Code:33513-8970
Practice Address - Country:US
Practice Address - Phone:352-793-3322
Practice Address - Fax:352-569-5820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-26
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH005256111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70873OtherBCBS
FLT85520Medicaid