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NPI Code Detail

MEDICARE: LANCE ROBERT FERKULA D.C.

MEDICARE: LANCE ROBERT FERKULA 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
1111N00000XChiropractor2361OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1311545465-00OTHEROHOHIO WORKER'S COMP
2001756443002OTHEROHUNITED HEALTHCARE
3000000121636OTHEROHANTHEM PROVIDER NUMBER

General Provider Information

NPI Number : 1518085059
Entity Type Code : Individual
Provider Name (Legal Business Name) : LANCE ROBERT FERKULA D.C.
Provider Business Mailing Address
First Line : 8487 IVY HILL DR
Second Line :
City : POLAND
State : OH
Zip : 44514-5214
Country : US
Telephone Number : 330-757-8480
Fax Number :
Provider Business Practice Location Address
First Line : 520 YOUNGSTOWN POLAND RD
Second Line :
City : STRUTHERS
State : OH
Zip : 44471-1103
Country : US
Telephone Number : 330-755-1199
Fax Number : 330-755-1299
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2007
Last Update Date : 07/08/2007

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Directions to “ LANCE ROBERT FERKULA D.C.” Practice Location

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