Provider Demographics
NPI:1184665812
Name:LANZARA, ANTHONY STEVEN (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:STEVEN
Last Name:LANZARA
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 1:1724 STATE RD
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-2842
Mailing Address - Country:US
Mailing Address - Phone:843-899-7200
Mailing Address - Fax:
Practice Address - Street 1:1724 STATE RD
Practice Address - Street 2:SUITE 1D
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-2842
Practice Address - Country:US
Practice Address - Phone:843-899-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH728-0704111N00000X
SC2945111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCF678Medicare PIN