MEDICARE: DR. LANCE ERIC MALMSTROM DC

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	111NX0800X	Orthopedic Chiropractor	01-03498	KS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	350011260	OTHER	KS	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	017503	OTHER	KS	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518051796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LANCE ERIC MALMSTROM DC

Provider Business Mailing Address
First Line	:	1520 SW TOPEKA BLVD
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66612-1851
Country	:	US
Telephone Number	:	785-235-1131
Fax Number	:	636-944-0514

Provider Business Practice Location Address
First Line	:	1520 SW TOPEKA BLVD
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66612-1851
Country	:	US
Telephone Number	:	785-235-1131
Fax Number	:	785-235-3771

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/30/2012

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