Provider Demographics
NPI:1275931230
Name:LENFEST, ALICE DAWN
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:DAWN
Last Name:LENFEST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2270 SILVER SANDS CT
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-3152
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2855 OCEAN DR
Practice Address - Street 2:B6
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32963-2039
Practice Address - Country:US
Practice Address - Phone:772-234-3433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005184L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor