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General NPI Number Information
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NPI Number | 1366757700
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Entity Type | Individual
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Provider Name | LORA JANE URIG D.C.
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Gender | Female
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Dates
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Enumeration Date | 08/10/2010
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Last Update Date | 06/13/2016
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Provider Practice Location Address
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Address Line | 1340 IMPERIAL BEACH BLVD 100
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City | IMPERIAL BEACH
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State | CA
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Zip | 91932-3046
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Country | US
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Telephone | 619-575-2588
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Fax |
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Provider Business Mailing Address
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Address Line | 4045 BONITA RD SUITE 203
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City | BONITA
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State | CA
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Zip | 91902-1334
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Country | US
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Telephone | 619-575-2588
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Fax | 619-764-4076
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DC31723
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License Number State | CA
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