Healthcare Provider Details
I. General information
NPI: 1023102670
Provider Name (Legal Business Name): LFCC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/03/2006
Last Update Date: 09/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1051 TOWN CENTER DR
ORANGE CITY FL
32763-8360
US
IV. Provider business mailing address
1051 TOWN CENTER DR
ORANGE CITY FL
32763-8360
US
V. Phone/Fax
- Phone: 386-775-3600
- Fax: 386-775-3602
- Phone: 386-775-3600
- Fax: 386-775-3602
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | CH8504 |
| License Number State | FL |
VIII. Authorized Official
Name: MRS.
TRICIA
KEELAN
LECHMAIER
Title or Position: PRESIDENT/ OWNER
Credential: D.C.
Phone: 407-834-2225