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NPI Code Detail

MEDICARE: DR. LISA DAWN PRUSINSKI D.C.

MEDICARE:  DR. LISA DAWN PRUSINSKI  D.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
1111N00000XChiropractor2097NC

Other Identifiers

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

General Provider Information

NPI Number : 1578660999
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LISA DAWN PRUSINSKI D.C.
Provider Business Mailing Address
First Line : 3750 SOUTH EVANS ST
Second Line : STE. C
City : GREENVILLE
State : NC
Zip : 27834-5412
Country : US
Telephone Number : 252-355-1770
Fax Number : 252-353-1415
Provider Business Practice Location Address
First Line : 3750 SOUTH EVANS ST
Second Line : STE. C
City : GREENVILLE
State : NC
Zip : 27834-5412
Country : US
Telephone Number : 252-355-1770
Fax Number : 252-353-1415
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 09/22/2008

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Directions to “ DR. LISA DAWN PRUSINSKI D.C.” Practice Location

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