Provider Demographics
NPI:1811290323
Name:LANSER CHIROPRACTIC INC
Entity type:Organization
Organization Name:LANSER CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:R
Authorized Official - Last Name:LANSER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:408-245-5454
Mailing Address - Street 1:990 W FREMONT AVE
Mailing Address - Street 2:SUITE P
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-3021
Mailing Address - Country:US
Mailing Address - Phone:408-245-5454
Mailing Address - Fax:408-245-5656
Practice Address - Street 1:990 W FREMONT AVE
Practice Address - Street 2:SUITE P
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3021
Practice Address - Country:US
Practice Address - Phone:408-245-5454
Practice Address - Fax:408-245-5656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-06
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0260850111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty