=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205024296
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALAN C. LENSGRAF DC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/04/2007
-----------------------------------------------------
Last Update Date | 06/16/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11320 KINGSTON PIKE
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37934-2858
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-675-2663
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11320 KINGSTON PIKE
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37934-2858
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-675-2663
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINIC DIRECTOR
-----------------------------------------------------
Name | DR. ALAN C LENSGRAF
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 865-675-2663
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC000000446
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------