Provider Demographics
NPI:1184021123
Name:LANCIAL CHIROPRACTIC
Entity Type:Organization
Organization Name:LANCIAL CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANCIAL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:712-624-8035
Mailing Address - Street 1:PO BOX 43
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:IA
Mailing Address - Zip Code:51551-0043
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:414 MAIN ST
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:IA
Practice Address - Zip Code:51551-8033
Practice Address - Country:US
Practice Address - Phone:712-624-8035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007578111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty