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General NPI Number Information
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NPI Number | 1053589820
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Entity Type | Organization
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Legal Business Name | LANCASTER CHIROPRACTIC LLC
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Dates
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Enumeration Date | 02/14/2008
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 4736 EAGLERIDGE CIR
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City | PUEBLO
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State | CO
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Zip | 81008-2120
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Country | US
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Telephone | 719-404-1489
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Fax | 719-545-0642
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Provider Business Mailing Address
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Address Line | 4736 EAGLERIDGE CIR
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City | PUEBLO
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State | CO
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Zip | 81008-2120
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Country | US
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Telephone | 719-404-1489
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Fax | 719-545-0642
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | DR. BETH ANN LANCASTER
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Credential | DC
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Telephone | 719-404-1489
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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 | 5271
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License Number State | CO
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