Provider Demographics
NPI:1093799231
Name:LINSENMAYER, NEIL LLOYD (DC)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:LLOYD
Last Name:LINSENMAYER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 E HOSPITAL RD
Mailing Address - Street 2:STE 3
Mailing Address - City:EL DORADO SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64744-2052
Mailing Address - Country:US
Mailing Address - Phone:417-876-0541
Mailing Address - Fax:417-876-0541
Practice Address - Street 1:605 E HOSPITAL RD
Practice Address - Street 2:STE 3
Practice Address - City:EL DORADO SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64744-2052
Practice Address - Country:US
Practice Address - Phone:417-876-0541
Practice Address - Fax:417-876-0541
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000144180111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
000031752Medicare ID - Type Unspecified
U78411Medicare UPIN