Provider Demographics
NPI:1609969096
Name:ORWICK, LISA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:MARIE
Last Name:ORWICK
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 1:7235 N PASEO DEL NORTE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-4412
Mailing Address - Country:US
Mailing Address - Phone:520-740-1718
Mailing Address - Fax:520-740-1776
Practice Address - Street 1:7235 N PASEO DEL NORTE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-4412
Practice Address - Country:US
Practice Address - Phone:520-740-1718
Practice Address - Fax:520-740-1776
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-30
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7005111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0942070OtherBCBS OF AZ
AZAZ0942070OtherBCBS OF AZ
AZZ74366Medicare PIN