Provider Demographics
NPI:1124213103
Name:LAMPE FAMILY CHIROPRACTIC PA
Entity Type:Organization
Organization Name:LAMPE FAMILY CHIROPRACTIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAMPE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:239-573-7988
Mailing Address - Street 1:601 DEL PRADO BLVD N
Mailing Address - Street 2:#5
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-2240
Mailing Address - Country:US
Mailing Address - Phone:239-573-7988
Mailing Address - Fax:239-573-7898
Practice Address - Street 1:601 DEL PRADO BLVD N
Practice Address - Street 2:#5
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-2240
Practice Address - Country:US
Practice Address - Phone:239-573-7988
Practice Address - Fax:239-573-7898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8529111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDC6380OtherRAILROAD MEDICARE
FL88115OtherBLUE CROSS BLUE SHIELD FL
FLU94950Medicare UPIN
FLDC6380OtherRAILROAD MEDICARE