MEDICARE: JOHN M LANEY 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	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1679190995
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN M LANEY DC

Provider Business Mailing Address
First Line	:	213 CAPITOL ST
Second Line	:
City	:	AUGUSTA
State	:	ME
Zip	:	04330-6232
Country	:	US
Telephone Number	:	207-623-4222
Fax Number	:	207-623-2343

Provider Business Practice Location Address
First Line	:	213 CAPITOL ST
Second Line	:
City	:	AUGUSTA
State	:	ME
Zip	:	04330-6232
Country	:	US
Telephone Number	:	207-623-4222
Fax Number	:	207-623-2343

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOHN MARK LANEY
Credential	:	DC
Telephone Number	:	207-623-4222

Provider Enumeration Date	:	07/02/2020
Last Update Date	:	07/02/2020

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