Provider Demographics
NPI:1578268108
Name:CIURO VAZQUEZ, LIZARIE M (DC)
Entity Type:Individual
Prefix:
First Name:LIZARIE
Middle Name:M
Last Name:CIURO VAZQUEZ
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 1:10306 SHELBYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2914
Mailing Address - Country:US
Mailing Address - Phone:502-245-7334
Mailing Address - Fax:502-245-7187
Practice Address - Street 1:10306 SHELBYVILLE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-2914
Practice Address - Country:US
Practice Address - Phone:502-245-7334
Practice Address - Fax:502-245-7187
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY284357111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor