MEDICARE: DR. AUDRA LANCE 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	2744	TN

General Provider Information

NPI Number	:	1588088041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AUDRA LANCE D.C.

Provider Business Mailing Address
First Line	:	2580 JORDAN RIDGE DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37218-3622
Country	:	US
Telephone Number	:	330-416-5647
Fax Number	:

Provider Business Practice Location Address
First Line	:	2580 JORDAN RIDGE DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37218-3622
Country	:	US
Telephone Number	:	330-416-5647
Fax Number	:

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

Provider Enumeration Date	:	02/04/2014
Last Update Date	:	02/04/2014

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