MEDICARE: DR. LORRAINE SCOTT GRAVANTE D.C.

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	111N00000X	Chiropractor	CHIR002063	GA

General Provider Information

NPI Number	:	1427144120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORRAINE SCOTT GRAVANTE D.C.

Provider Business Mailing Address
First Line	:	2795 MAIN ST W BLDG 14
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-3164
Country	:	US
Telephone Number	:	678-990-9400
Fax Number	:	678-990-9405

Provider Business Practice Location Address
First Line	:	2795 MAIN ST W BLDG 14
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-3164
Country	:	US
Telephone Number	:	678-990-9400
Fax Number	:	678-990-9405

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

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	10/10/2025

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