Provider Demographics
NPI:1114088655
Name:LEHANE, KEVIN DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:DAVID
Last Name:LEHANE
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 1:70 BRIDGE ST
Mailing Address - Street 2:SUITE #3
Mailing Address - City:PELHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03076-3419
Mailing Address - Country:US
Mailing Address - Phone:603-370-8541
Mailing Address - Fax:
Practice Address - Street 1:70 BRIDGE ST
Practice Address - Street 2:SUITE #3
Practice Address - City:PELHAM
Practice Address - State:NH
Practice Address - Zip Code:03076-3419
Practice Address - Country:US
Practice Address - Phone:603-370-8541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2923111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2179477Medicaid
OH9315711Medicare ID - Type Unspecified