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General NPI Number Information
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NPI Number | 1619484888
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Entity Type | Organization
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Legal Business Name | LSS MEDICAL PLLC
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Dates
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Enumeration Date | 01/09/2018
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Last Update Date | 01/09/2018
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Provider Practice Location Address
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Address Line | 173 S INTERSTATE 35
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City | NEW BRAUNFELS
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State | TX
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Zip | 78130-4817
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Country | US
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Telephone | 830-358-1446
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Fax | 830-358-1646
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Provider Business Mailing Address
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Address Line | PO BOX 47626
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City | SAN ANTONIO
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State | TX
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Zip | 78265-8626
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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 | CEO
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Name | COREY SORUM
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Credential | DC
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Telephone | 830-358-1446
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number |
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License Number State |
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