Provider Demographics
NPI:1174817944
Name:UGOLIK, LORI L (DC)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:L
Last Name:UGOLIK
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 1:1095 HOOTEN DR.
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRINGS
Mailing Address - State:NV
Mailing Address - Zip Code:89429
Mailing Address - Country:US
Mailing Address - Phone:775-426-9296
Mailing Address - Fax:478-743-2402
Practice Address - Street 1:TAHOA BLVD CHIROPRACTIC
Practice Address - Street 2:923 TAHOE BLVD STE. 110 C
Practice Address - City:INCLINE VILLAGE
Practice Address - State:NV
Practice Address - Zip Code:89451
Practice Address - Country:US
Practice Address - Phone:775-426-9296
Practice Address - Fax:478-743-2402
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005023111N00000X
NVB01637111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor