Provider Demographics
NPI:1972500890
Name:LORBER, TRICIA ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:TRICIA
Middle Name:ANN
Last Name:LORBER
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 1:6165 NW 86TH ST
Mailing Address - Street 2:STE. 110
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-2270
Mailing Address - Country:US
Mailing Address - Phone:515-331-2555
Mailing Address - Fax:515-727-1606
Practice Address - Street 1:6165 NW 86TH ST
Practice Address - Street 2:STE. 110
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-2270
Practice Address - Country:US
Practice Address - Phone:515-331-2555
Practice Address - Fax:515-727-1606
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06388111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
I11549Medicare ID - Type Unspecified
IAU98833Medicare UPIN