1174817944 NPI number — DR. LORI L UGOLIK D.C.

Table of content: DR. LORI L UGOLIK D.C. (NPI 1174817944)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174817944 NPI number — DR. LORI L UGOLIK D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
UGOLIK
Provider First Name:
LORI
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174817944
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1095 HOOTEN DR.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SILVER SPRINGS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89429
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
775-426-9296
Provider Business Mailing Address Fax Number:
478-743-2402

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
TAHOA BLVD CHIROPRACTIC
Provider Second Line Business Practice Location Address:
923 TAHOE BLVD STE. 110 C
Provider Business Practice Location Address City Name:
INCLINE VILLAGE
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89451
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-426-9296
Provider Business Practice Location Address Fax Number:
478-743-2402
Provider Enumeration Date:
06/08/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  005023 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 111N00000X , with the licence number: B01637 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)