MEDICARE: DR. LEE ANTHONY MEYLOR 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	05020	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164423349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEE ANTHONY MEYLOR D.C.

Provider Business Mailing Address
First Line	:	PO BOX 334
Second Line	:
City	:	STORM LAKE
State	:	IA
Zip	:	50588-0334
Country	:	US
Telephone Number	:	712-732-7280
Fax Number	:	712-732-7281

Provider Business Practice Location Address
First Line	:	1411 E LAKESHORE DR
Second Line	:
City	:	STORM LAKE
State	:	IA
Zip	:	50588-2683
Country	:	US
Telephone Number	:	712-732-7280
Fax Number	:	712-732-7281

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	07/08/2007

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