Healthcare Provider Details

I. General information

NPI: 1881619179
Provider Name (Legal Business Name): KAREN LORD DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 10/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1122 W C 48
BUSHNELL FL
33513-8970
US

IV. Provider business mailing address

483 E C 48
BUSHNELL FL
33513-8331
US

V. Phone/Fax

Practice location:
  • Phone: 352-793-3322
  • Fax: 352-569-5820
Mailing address:
  • Phone: 352-793-3322
  • Fax: 352-569-5820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH005256
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: