MEDICARE: DR. LANCE A CASAZZA DC

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	DC 28041	CA

General Provider Information

NPI Number	:	1922097641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LANCE A CASAZZA DC

Provider Business Mailing Address
First Line	:	2716 V ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95818-1901
Country	:	US
Telephone Number	:	916-447-2200
Fax Number	:	916-447-7930

Provider Business Practice Location Address
First Line	:	2716 V ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95818-1901
Country	:	US
Telephone Number	:	916-447-2200
Fax Number	:	916-447-7930

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

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	05/30/2008

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