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General NPI Number Information
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NPI Number | 1710701859
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Entity Type | Individual
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Provider Name | EVA LECTORA DC
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Gender | Female
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Dates
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Enumeration Date | 11/14/2024
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 305 W PIKE ST
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-3212
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Country | US
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Telephone | 404-900-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 1163 W PEACHTREE ST NE APT 1606
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City | ATLANTA
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State | GA
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Zip | 30309-4541
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Country | US
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Telephone | 787-638-4505
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Fax |
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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 | CHIR011255
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License Number State | GA
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