MEDICARE: LORI LINETTE ANTMAN

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	DC4392	TX

General Provider Information

NPI Number	:	1629102231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI LINETTE ANTMAN

Provider Business Mailing Address
First Line	:	4623 FORT CROCKETT BLVD
Second Line	:
City	:	GALVESTON
State	:	TX
Zip	:	77551-5962
Country	:	US
Telephone Number	:	409-935-4467
Fax Number	:

Provider Business Practice Location Address
First Line	:	4623 FORT CROCKETT BLVD
Second Line	:
City	:	GALVESTON
State	:	TX
Zip	:	77551-5962
Country	:	US
Telephone Number	:	409-762-7646
Fax Number	:

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

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	11/21/2016

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Directions to “ LORI LINETTE ANTMAN ” Practice Location

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