MEDICARE: MOTION WELLNESS & CHIROPRACTIC DR. PO LEKNICKAS, 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-30053	CA

General Provider Information

NPI Number	:	1154688984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOTION WELLNESS & CHIROPRACTIC DR. PO LEKNICKAS, INC.

Provider Business Mailing Address
First Line	:	10170 CULVER BLVD
Second Line	:	STE 102
City	:	CULVER CITY
State	:	CA
Zip	:	90232-3152
Country	:	US
Telephone Number	:	310-314-5500
Fax Number	:

Provider Business Practice Location Address
First Line	:	10170 CULVER BLVD
Second Line	:	STE 102
City	:	CULVER CITY
State	:	CA
Zip	:	90232-3152
Country	:	US
Telephone Number	:	310-314-5500
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CHIROPRACTOR
Name	:	DR. POVILAS LEKNICKAS
Credential	:	D.C.
Telephone Number	:	310-314-5500

Provider Enumeration Date	:	04/18/2012
Last Update Date	:	01/16/2014

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