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General NPI Number Information
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NPI Number | 1497142467
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Entity Type | Organization
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Legal Business Name | JEFFREY LINCOLN DC PA
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Dates
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Enumeration Date | 04/17/2015
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Last Update Date | 04/17/2015
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Provider Practice Location Address
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Address Line | 1122 W C 48
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City | BUSHNELL
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State | FL
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Zip | 33513-8970
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Country | US
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Telephone | 352-793-3322
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Fax |
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Provider Business Mailing Address
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Address Line | 11178 SW 51ST DR
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City | WEBSTER
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State | FL
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Zip | 33597-7267
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Country | US
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Telephone | 352-793-3322
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY LINCOLN
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Credential | DC
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Telephone | 352-793-3322
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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 | CH 6992
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License Number State | FL
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