Provider Demographics
NPI:1316198070
Name:LEX, JANINE WILTSE (DC)
Entity Type:Individual
Prefix:DR
First Name:JANINE
Middle Name:WILTSE
Last Name:LEX
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 1:2245 W GREAT NECK RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-1525
Mailing Address - Country:US
Mailing Address - Phone:757-491-2598
Mailing Address - Fax:
Practice Address - Street 1:2245 W GREAT NECK RD
Practice Address - Street 2:SUITE 4
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-1525
Practice Address - Country:US
Practice Address - Phone:757-491-2598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000505111N00000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist