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General NPI Number Information
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NPI Number | 1043687916
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Entity Type | Organization
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Legal Business Name | LEWISBURG SPORT & SPINE CHIROPRACTIC CENTER LLC
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Dates
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Enumeration Date | 08/27/2015
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Last Update Date | 11/18/2015
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Provider Practice Location Address
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Address Line | 114 MARKET ST
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City | LEWISBURG
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State | PA
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Zip | 17837-1542
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Country | US
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Telephone | 570-412-2090
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Fax |
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Provider Business Mailing Address
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Address Line | 114 MARKET ST
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City | LEWISBURG
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State | PA
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Zip | 17837-1542
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Country | US
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Telephone | 570-768-4026
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Fax | 570-768-4029
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Authorized Official
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Title or Position | CHIROPRACTOR / OWNER
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Name | DR. LONNI LYNETTE ERNST DANCY
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Credential | D.C.
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Telephone | 570-412-2090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC011061
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License Number State | PA
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