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General NPI Number Information
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NPI Number | 1255514675
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Entity Type | Organization
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Legal Business Name | LORD SPINAL CARE SC
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 6220 NESBITT RD
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City | FITCHBURG
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State | WI
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Zip | 53719-1829
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Country | US
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Telephone | 608-442-7400
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Fax | 608-442-1105
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Provider Business Mailing Address
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Address Line | 6220 NESBITT RD
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City | FITCHBURG
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State | WI
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Zip | 53719-1829
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CHIROPRACTOR
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Name | DR. KATHERINE LORD
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Credential | DC
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Telephone | 608-442-7400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3992
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License Number State | WI
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