Provider Demographics
NPI:1245532860
Name:GARD, LANCE N (DC)
Entity type:Individual
Prefix:DR
First Name:LANCE
Middle Name:N
Last Name:GARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 SWIFTSIDE DR STE 103
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-7200
Mailing Address - Country:US
Mailing Address - Phone:919-322-4383
Mailing Address - Fax:919-585-5568
Practice Address - Street 1:455 SWIFTSIDE DR STE 103
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7200
Practice Address - Country:US
Practice Address - Phone:919-322-4383
Practice Address - Fax:919-585-5568
Is Sole Proprietor?:No
Enumeration Date:2010-12-02
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4123111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1851693485OtherNPPES
NC1538463542OtherNPPES