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General NPI Number Information
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NPI Number | 1134138332
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Entity Type | Individual
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Provider Name | MICHAEL LICHTMAN CNIM
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 20100 N 78TH PL APT 2088
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-3838
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Country | US
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Telephone | 602-292-1455
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Fax |
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Provider Business Mailing Address
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Address Line | 20100 N 78TH PL APT 2088
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-3838
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Country | US
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Telephone | 602-292-1455
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 5702
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number | 1721
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License Number State | AZ
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