MEDICARE: LANE S. BAUER D.C.

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	972	NM

General Provider Information

NPI Number	:	1124179205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LANE S. BAUER D.C.

Provider Business Mailing Address
First Line	:	1265 S MAIN ST
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-3122
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1265 S MAIN ST
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-3122
Country	:	US
Telephone Number	:	505-524-4494
Fax Number	:	505-523-2526

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2007
Last Update Date	:	07/08/2007

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Directions to “ LANE S. BAUER D.C.” Practice Location

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