MEDICARE: DR. LACEY ANN MINK D.C.

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	1736	NE

General Provider Information

NPI Number	:	1497008346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LACEY ANN MINK D.C.

Provider Business Mailing Address
First Line	:	27100 RANCH RD
Second Line	:
City	:	ASHLAND
State	:	NE
Zip	:	68003-3514
Country	:	US
Telephone Number	:	402-322-0098
Fax Number	:

Provider Business Practice Location Address
First Line	:	1409 SILVER ST
Second Line	:
City	:	ASHLAND
State	:	NE
Zip	:	68003-1845
Country	:	US
Telephone Number	:	402-322-0098
Fax Number	:

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

Provider Enumeration Date	:	10/16/2012
Last Update Date	:	12/17/2015

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Directions to “ DR. LACEY ANN MINK D.C.” Practice Location

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