Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | CHIRO09081 | GA |
N | 111NN0400X | Neurology | CHIRO09081 | GA |
N | 111NN1001X | Nutrition | CHIRO09081 | GA |
N | 111NP0017X | Pediatric Chiropractor | CHIRO09081 | GA |
N | 111NR0400X | Rehabilitation Chiropractor | CHIRO09081 | GA |
N | 111NS0005X | Chiropractic Sports Physician | CHIRO09081 | GA |
NPI | 1700163508 |
---|---|
Provider Name | Claire S Lavan |
First Address | Marietta, GA 30067-1661 |
Second Address | Lawrenceville, GA 30045-9402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2011 |
Last Update Date | 08/01/2013 |