MEDICARE: LORENA WENGER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1810	NE

General Provider Information

NPI Number	:	1346659315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORENA WENGER

Provider Business Mailing Address
First Line	:	1530 17TH AVE
Second Line	:
City	:	CENTRAL CITY
State	:	NE
Zip	:	68826-1766
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1530 17TH AVE
Second Line	:
City	:	CENTRAL CITY
State	:	NE
Zip	:	68826-1766
Country	:	US
Telephone Number	:	605-830-0439
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2014
Last Update Date	:	08/04/2014

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Directions to “ LORENA WENGER ” Practice Location

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