Provider Demographics
NPI:1427383934
Name:LEHIGH CHIROPRACTIC ASSOCIATES CORP
Entity Type:Organization
Organization Name:LEHIGH CHIROPRACTIC ASSOCIATES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAZ
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:239-303-1139
Mailing Address - Street 1:1303 HOMESTEAD RD N STE 102
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-6049
Mailing Address - Country:US
Mailing Address - Phone:239-303-1139
Mailing Address - Fax:239-303-1839
Practice Address - Street 1:1303 HOMESTEAD RD N STE 102
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-6049
Practice Address - Country:US
Practice Address - Phone:239-303-1139
Practice Address - Fax:239-303-1839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH-4496261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center