MEDICARE: NEW HEIGHTS CHIROPRACTIC AND WELLNESS CLINIC, PC

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

General Provider Information

NPI Number	:	1598234429
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW HEIGHTS CHIROPRACTIC AND WELLNESS CLINIC, PC

Provider Business Mailing Address
First Line	:	155 ALTA VISTA RD STE B
Second Line	:
City	:	EAGLE POINT
State	:	OR
Zip	:	97524-9735
Country	:	US
Telephone Number	:	541-879-3443
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 ALTA VISTA RD STE B
Second Line	:
City	:	EAGLE POINT
State	:	OR
Zip	:	97524-9735
Country	:	US
Telephone Number	:	541-879-3443
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LEIGH F LENZ
Credential	:	DC
Telephone Number	:	541-879-3443

Provider Enumeration Date	:	11/20/2018
Last Update Date	:	11/20/2018

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