| Lantz Chiropractic, Pa | |
|
3440 Federal Dr Suite 120 Eagan MN 55122-3501 | |
| (612) 584-0220 | |
| (651) 403-5643 |
| Full Name | Lantz Chiropractic, Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 3440 Federal Dr, Eagan, Minnesota |
| Authorized Official Name and Position | Nicole Kristin Lantz (OWNER) |
| Authorized Official Contact | 6125840220 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lantz Chiropractic, Pa 3440 Federal Dr Suite 120 Eagan MN 55122-3501 Ph: (612) 584-0220 | Lantz Chiropractic, Pa 3440 Federal Dr Suite 120 Eagan MN 55122-3501 Ph: (612) 584-0220 |
| NPI Number | 1497014500 |
|---|---|
| Provider Enumeration Date | 05/09/2012 |
| Last Update Date | 05/09/2012 |
| Medicare PECOS PAC ID | 0840454989 |
|---|---|
| Medicare Enrollment ID | O20120621000050 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497014500 | NPI | - | NPPES |
| 265400800 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 4303 (Minnesota) | Primary |
| Provider Name | Nicole K Lantz |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1952410045 PECOS PAC ID: 5395704142 Enrollment ID: I20041011000551 |
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