Provider Demographics
NPI:1487701629
Name:REASOR-BURTON, LOLITA ANN (DC)
Entity type:Individual
Prefix:DR
First Name:LOLITA
Middle Name:ANN
Last Name:REASOR-BURTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8575 W COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:FRENCH LICK
Mailing Address - State:IN
Mailing Address - Zip Code:47432-1060
Mailing Address - Country:US
Mailing Address - Phone:812-936-4920
Mailing Address - Fax:
Practice Address - Street 1:1670 W MAIN ST
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:IN
Practice Address - Zip Code:47454-9665
Practice Address - Country:US
Practice Address - Phone:812-723-2277
Practice Address - Fax:812-723-2477
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001140A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor