Provider Demographics
NPI:1942333695
Name:LONNIE PEETS PC
Entity Type:Organization
Organization Name:LONNIE PEETS PC
Other - Org Name:LIFETIME CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEETS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:505-891-3111
Mailing Address - Street 1:4111 BARBARA LOOP SE
Mailing Address - Street 2:SUITE C1
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-1068
Mailing Address - Country:US
Mailing Address - Phone:505-891-3111
Mailing Address - Fax:888-289-9241
Practice Address - Street 1:4111 BARBARA LOOP SE
Practice Address - Street 2:SUITE C1
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1068
Practice Address - Country:US
Practice Address - Phone:505-891-3111
Practice Address - Fax:888-289-9241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1071111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty