Provider Demographics
NPI:1164545935
Name:LEIN, LUCIA JANE (DC)
Entity Type:Individual
Prefix:DR
First Name:LUCIA
Middle Name:JANE
Last Name:LEIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12527 CENTRAL AVE NE # 119
Mailing Address - Street 2:119
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55434-4861
Mailing Address - Country:US
Mailing Address - Phone:651-766-4600
Mailing Address - Fax:
Practice Address - Street 1:1000 W. COUNTY RD. E
Practice Address - Street 2:210
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126
Practice Address - Country:US
Practice Address - Phone:651-766-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2634111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor