=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467972745
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SANZI CHIROPRACTIC, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/27/2017
-----------------------------------------------------
Last Update Date | 06/27/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 426 AIRPORT RD STE 132-A
-----------------------------------------------------
City | HAZLE TOWNSHIP
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18202-3361
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-956-7085
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 426 AIRPORT RD STE 132-A
-----------------------------------------------------
City | HAZLE TOWNSHIP
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18202-3361
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. LAUREN SANZI
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 570-956-7085
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC011235
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------