MEDICARE: DR. LORI PUSKAR DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NN1001X	Nutrition Chiropractor	CH11944	FL

General Provider Information

NPI Number	:	1083139240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORI PUSKAR DC

Provider Business Mailing Address
First Line	:	507 N LINCOLN AVE
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33755-4733
Country	:	US
Telephone Number	:	727-729-2861
Fax Number	:

Provider Business Practice Location Address
First Line	:	1171 NE CLEVELAND ST
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33755-4815
Country	:	US
Telephone Number	:	727-729-2861
Fax Number	:	727-447-1702

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2017
Last Update Date	:	08/09/2017

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Directions to “ DR. LORI PUSKAR DC” Practice Location

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