Provider Demographics
NPI:1134142581
Name:LESNESKI, LANCE (DC)
Entity Type:Individual
Prefix:DR
First Name:LANCE
Middle Name:
Last Name:LESNESKI
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 1:40 CALEDONIA STREET
Mailing Address - Street 2:
Mailing Address - City:SAUSALITO
Mailing Address - State:CA
Mailing Address - Zip Code:94965
Mailing Address - Country:US
Mailing Address - Phone:415-332-0544
Mailing Address - Fax:415-332-9476
Practice Address - Street 1:40 CALEDONIA STREET
Practice Address - Street 2:
Practice Address - City:SAUSALITO
Practice Address - State:CA
Practice Address - Zip Code:94965
Practice Address - Country:US
Practice Address - Phone:415-332-0544
Practice Address - Fax:415-332-9476
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0113320111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0113320OtherSTATE BOARD OF CHIROPRACT