Healthcare Provider Details

I. General information

NPI: 1952589947
Provider Name (Legal Business Name): LINDSEY M JACCARD D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2008
Last Update Date: 09/09/2020
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 MARKET ST
LA CYGNE KS
66040-4123
US

IV. Provider business mailing address

PO BOX 53
LA CYGNE KS
66040-0053
US

V. Phone/Fax

Practice location:
  • Phone: 913-757-4044
  • Fax: 913-757-3223
Mailing address:
  • Phone: 913-709-2364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5141
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: