Provider Demographics
NPI:1245433747
Name:LEKNICKAS, POVILAS MINDAUGAS (DC)
Entity type:Individual
Prefix:DR
First Name:POVILAS
Middle Name:MINDAUGAS
Last Name:LEKNICKAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10170 CULVER BLVD
Mailing Address - Street 2:STE 102
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-3152
Mailing Address - Country:US
Mailing Address - Phone:310-314-5500
Mailing Address - Fax:310-684-5777
Practice Address - Street 1:10170 CULVER BLVD
Practice Address - Street 2:STE 102
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-3152
Practice Address - Country:US
Practice Address - Phone:310-314-5500
Practice Address - Fax:310-684-5777
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011420111N00000X
CA30053111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor