Provider Demographics
NPI:1679536452
Name:SPECKMAN, ELIZABETH L (DC)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:L
Last Name:SPECKMAN
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 1:150 S EL MOLINO AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2565
Mailing Address - Country:US
Mailing Address - Phone:626-844-7451
Mailing Address - Fax:626-844-7451
Practice Address - Street 1:150 S EL MOLINO AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2565
Practice Address - Country:US
Practice Address - Phone:626-844-7451
Practice Address - Fax:626-844-7451
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 30068111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor