Provider Demographics
NPI:1174641435
Name:LANSING CHIROPRACTIC OFFICE, PC
Entity Type:Organization
Organization Name:LANSING CHIROPRACTIC OFFICE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:607-533-4231
Mailing Address - Street 1:15 AUBURN RD
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:NY
Mailing Address - Zip Code:14882-9093
Mailing Address - Country:US
Mailing Address - Phone:607-533-4231
Mailing Address - Fax:607-533-4232
Practice Address - Street 1:15 AUBURN RD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:NY
Practice Address - Zip Code:14882-9093
Practice Address - Country:US
Practice Address - Phone:607-533-4231
Practice Address - Fax:607-533-4232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX03261111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCO32617OtherWORKERS' COMP
NY14067OtherBLUE CROSS
NY54624CMedicare ID - Type Unspecified
NYCO32617OtherWORKERS' COMP