MEDICARE: LYHNE CHIROPRACTIC, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC 29369	CA

General Provider Information

NPI Number	:	1114027935
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LYHNE CHIROPRACTIC, INC.

Provider Business Mailing Address
First Line	:	801 SAN RAMON VALLEY BLVD STE B
Second Line	:
City	:	DANVILLE
State	:	CA
Zip	:	94526-4027
Country	:	US
Telephone Number	:	925-820-1500
Fax Number	:	925-820-5175

Provider Business Practice Location Address
First Line	:	801 SAN RAMON VALLEY BLVD STE B
Second Line	:
City	:	DANVILLE
State	:	CA
Zip	:	94526-4027
Country	:	US
Telephone Number	:	925-820-1500
Fax Number	:	925-820-5175

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	JACOB LYHNE
Credential	:	D.C.
Telephone Number	:	925-820-1500

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	08/22/2020

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