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General NPI Number Information
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NPI Number | 1952581639
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Entity Type | Individual
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Provider Name | LORIE ALICIA CHADWICK
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Gender | Female
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Dates
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Enumeration Date | 11/09/2007
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Last Update Date | 11/09/2007
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Provider Practice Location Address
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Address Line | 8019 S. COMPTON AVE
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City | LOS ANGELES
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State | CA
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Zip | 90001
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Country | US
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Telephone | 310-436-6101
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Fax |
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Provider Business Mailing Address
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Address Line | 13522 CHADRON AVE APT#103
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City | HAWTHORNE
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State | CA
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Zip | 90250-9232
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Country | US
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Telephone | 310-491-6165
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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 | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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