MEDICARE: LANIER CHIROPRACTIC, PROFESSIONAL CORPORATION

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	33282	CA

General Provider Information

NPI Number	:	1285185041
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LANIER CHIROPRACTIC, PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	23412 MOULTON PKWY
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-1732
Country	:	US
Telephone Number	:	949-770-6096
Fax Number	:

Provider Business Practice Location Address
First Line	:	23412 MOULTON PKWY
Second Line	:	100
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-1732
Country	:	US
Telephone Number	:	949-770-6096
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. TIMOTHY DAVID LANIER
Credential	:	D.C.
Telephone Number	:	214-395-7851

Provider Enumeration Date	:	10/17/2016
Last Update Date	:	12/20/2016

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