Provider Demographics
NPI:1184983991
Name:LANCE CHIROPRACTIC FAMILY CLINIC, PLLC
Entity type:Organization
Organization Name:LANCE CHIROPRACTIC FAMILY CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LANCE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-334-0100
Mailing Address - Street 1:880 LAWRENCE RD
Mailing Address - Street 2:#180
Mailing Address - City:KEMAH
Mailing Address - State:TX
Mailing Address - Zip Code:77565-2707
Mailing Address - Country:US
Mailing Address - Phone:281-334-0100
Mailing Address - Fax:281-334-0108
Practice Address - Street 1:880 LAWRENCE RD
Practice Address - Street 2:#180
Practice Address - City:KEMAH
Practice Address - State:TX
Practice Address - Zip Code:77565-2707
Practice Address - Country:US
Practice Address - Phone:281-334-0100
Practice Address - Fax:281-334-0108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11983111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty