Provider Demographics
NPI:1467675199
Name:MEYER, LON L (DC)
Entity type:Individual
Prefix:DR
First Name:LON
Middle Name:L
Last Name:MEYER
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 1:17 4TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:KASSON
Mailing Address - State:MN
Mailing Address - Zip Code:55944-1161
Mailing Address - Country:US
Mailing Address - Phone:507-634-6111
Mailing Address - Fax:507-634-7475
Practice Address - Street 1:17 4TH AVE NW
Practice Address - Street 2:
Practice Address - City:KASSON
Practice Address - State:MN
Practice Address - Zip Code:55944-1161
Practice Address - Country:US
Practice Address - Phone:507-634-6111
Practice Address - Fax:507-634-7475
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1567111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNCO6826Medicare PIN
MNT-65862Medicare UPIN