Healthcare Provider Details

I. General information

NPI: 1679771760
Provider Name (Legal Business Name): JAMIE M LENZ D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S WHITNEY WAY
MADISON WI
53711-6274
US

IV. Provider business mailing address

1001 S WHITNEY WAY
MADISON WI
53711-6274
US

V. Phone/Fax

Practice location:
  • Phone: 608-274-6200
  • Fax: 608-278-4586
Mailing address:
  • Phone: 608-274-6200
  • Fax: 608-278-4586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number30434
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number4502-012
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number4501-012
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: