Provider Demographics
NPI:1508004045
Name:LORI S. PRESCOTT, A CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:LORI S. PRESCOTT, A CHIROPRACTIC CORPORATION
Other - Org Name:PAIN AND POSTURE CORRECTION CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:PRESCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:714-585-5651
Mailing Address - Street 1:33 CREEK RD
Mailing Address - Street 2:SUITE C-320
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4791
Mailing Address - Country:US
Mailing Address - Phone:949-784-4507
Mailing Address - Fax:949-872-2812
Practice Address - Street 1:33 CREEK RD
Practice Address - Street 2:SUITE C-320
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4791
Practice Address - Country:US
Practice Address - Phone:949-784-4507
Practice Address - Fax:949-872-2812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-21
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16143111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty