MEDICARE: DR. LETHA ARENCHILD FAIR 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	22932 CA	CA

General Provider Information

NPI Number	:	1134264252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LETHA ARENCHILD FAIR D.C.

Provider Business Mailing Address
First Line	:	2084 MOONSTONE CIR
Second Line	:
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-4345
Country	:	US
Telephone Number	:	916-690-6763
Fax Number	:	916-933-5148

Provider Business Practice Location Address
First Line	:	2084 MOONSTONE CIR
Second Line	:
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-4345
Country	:	US
Telephone Number	:	916-690-6763
Fax Number	:	916-933-5148

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

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	07/08/2007

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