MEDICARE: LENZ CHIROPRACTIC, 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	:	1669536892
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LENZ CHIROPRACTIC, PC

Provider Business Mailing Address
First Line	:	3030 AVENUE H
Second Line	:
City	:	WHITE CITY
State	:	OR
Zip	:	97503-1341
Country	:	US
Telephone Number	:	541-826-6800
Fax Number	:	541-826-7008

Provider Business Practice Location Address
First Line	:	3030 AVENUE H
Second Line	:
City	:	WHITE CITY
State	:	OR
Zip	:	97503-1341
Country	:	US
Telephone Number	:	541-826-6800
Fax Number	:	541-826-7008

Authorized Official
Title or Position	:	VICE PRESIDENT, SECRETARY
Name	:	DR. LEIGH F LENZ
Credential	:	D.C.
Telephone Number	:	541-826-6800

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	09/05/2013

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