Provider Demographics
NPI:1245456516
Name:LANSING CHIROPRACTIC CLINIC, PC
Entity type:Organization
Organization Name:LANSING CHIROPRACTIC CLINIC, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:SEVERANCE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:517-581-2785
Mailing Address - Street 1:6000 W ST JOE HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-4873
Mailing Address - Country:US
Mailing Address - Phone:517-323-2500
Mailing Address - Fax:517-323-3161
Practice Address - Street 1:6000 W ST JOE HWY STE 101
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-4873
Practice Address - Country:US
Practice Address - Phone:517-323-2500
Practice Address - Fax:517-323-3161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty