Provider Demographics
NPI:1710701859
Name:LECTORA, EVA (DC)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:LECTORA
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 1:1163 W PEACHTREE ST NE APT 1606
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-4541
Mailing Address - Country:US
Mailing Address - Phone:787-638-4505
Mailing Address - Fax:
Practice Address - Street 1:305 W PIKE ST
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-3212
Practice Address - Country:US
Practice Address - Phone:404-900-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR011255111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor