Healthcare Provider Details

I. General information

NPI: 1649138603
Provider Name (Legal Business Name): LENAH RICKLY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 OLD STATE ROUTE 74
BATAVIA OH
45103-1501
US

IV. Provider business mailing address

PO BOX 700688
SAN ANTONIO TX
78270-0688
US

V. Phone/Fax

Practice location:
  • Phone: 800-404-6050
  • Fax:
Mailing address:
  • Phone: 800-404-6050
  • Fax: 866-313-3397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number16735
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-05573
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: