MEDICARE: MR. STEVEN GEORGE LINGBECK DC DR OF CHIROPRACTI

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	2064	MN

General Provider Information

NPI Number	:	1225196926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEVEN GEORGE LINGBECK DC DR OF CHIROPRACTI

Provider Business Mailing Address
First Line	:	PO BOX 297
Second Line	:
City	:	MAPLE PLAIN
State	:	MN
Zip	:	55359
Country	:	US
Telephone Number	:	763-479-3174
Fax Number	:	763-479-3174

Provider Business Practice Location Address
First Line	:	5420 HIGHWAY 12
Second Line	:
City	:	MAPLE PLAIN
State	:	MN
Zip	:	55359
Country	:	US
Telephone Number	:	763-479-3174
Fax Number	:	763-479-3174

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

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	07/08/2007

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