Provider Demographics
NPI:1255469995
Name:OKUN, LORI A (DC)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:A
Last Name:OKUN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:LORI
Other - Middle Name:A
Other - Last Name:POKRASSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:6703 SHANNON PKWY
Mailing Address - Street 2:STE 13-14
Mailing Address - City:UNION CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30291-2073
Mailing Address - Country:US
Mailing Address - Phone:770-964-3334
Mailing Address - Fax:770-306-2680
Practice Address - Street 1:6703 SHANNON PKWY
Practice Address - Street 2:13-14
Practice Address - City:UNION CITY
Practice Address - State:GA
Practice Address - Zip Code:30291-2073
Practice Address - Country:US
Practice Address - Phone:770-964-3334
Practice Address - Fax:770-306-2680
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR002851111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA58-2155004OtherTAX ID
GA202I357030Medicare UPIN