Provider Demographics
NPI:1598871105
Name:LAVOOK, LYNN R (DC)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:R
Last Name:LAVOOK
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 1:5017 HIXSON PIKE # B
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-3952
Mailing Address - Country:US
Mailing Address - Phone:423-875-3800
Mailing Address - Fax:423-877-7226
Practice Address - Street 1:5017 HIXSON PIKE # B
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-3952
Practice Address - Country:US
Practice Address - Phone:423-875-3800
Practice Address - Fax:423-877-7226
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN01084111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3676943Medicaid
TN0168572OtherBCBS OF TN
TN5016940OtherCIGNA
TNU45809Medicare UPIN
TN3676943Medicare ID - Type Unspecified