Provider Demographics
NPI:1548280183
Name:GREITZER, LAURI LAWTON (DC)
Entity type:Individual
Prefix:DR
First Name:LAURI
Middle Name:LAWTON
Last Name:GREITZER
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 1:5910 CLARK RD STE Q
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-4860
Mailing Address - Country:US
Mailing Address - Phone:530-877-3333
Mailing Address - Fax:
Practice Address - Street 1:5910 CLARK RD STE Q
Practice Address - Street 2:
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969-4860
Practice Address - Country:US
Practice Address - Phone:530-877-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20283111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC20283Medicare ID - Type Unspecified
CAU40369Medicare UPIN