Provider Demographics
NPI:1871968313
Name:LAMANA, KRISTINE GEORGIA (DC)
Entity type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:GEORGIA
Last Name:LAMANA
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 1:240 S. PALMETTO AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114
Mailing Address - Country:US
Mailing Address - Phone:386-310-2385
Mailing Address - Fax:386-233-9488
Practice Address - Street 1:240 S. PALMETTO AVE
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114
Practice Address - Country:US
Practice Address - Phone:386-310-2385
Practice Address - Fax:386-233-9488
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-09
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11723111N00000X
FLCH11723111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor