MEDICARE: DR. GREGORY P LONSCAK DC, DNP, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2493	SC
2	363LF0000X	Family Nurse Practitioner	18114	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386613172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY P LONSCAK DC, DNP, FNP-C

Provider Business Mailing Address
First Line	:	14 CROSSINGS BLVD
Second Line	:
City	:	BLUFFTON
State	:	SC
Zip	:	29910-7840
Country	:	US
Telephone Number	:	843-247-3655
Fax Number	:

Provider Business Practice Location Address
First Line	:	1718 RIBAUT RD
Second Line	:
City	:	PORT ROYAL
State	:	SC
Zip	:	29935-1927
Country	:	US
Telephone Number	:	843-986-0900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	11/22/2018

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