Provider Demographics
NPI:1912911637
Name:ATCHLEY, LYMAN S (DC)
Entity Type:Individual
Prefix:
First Name:LYMAN
Middle Name:S
Last Name:ATCHLEY
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 1:8004 PENN CIRCLE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-7824
Mailing Address - Country:US
Mailing Address - Phone:505-265-5651
Mailing Address - Fax:505-268-0820
Practice Address - Street 1:8004 PENN CIRCLE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-7824
Practice Address - Country:US
Practice Address - Phone:505-265-5651
Practice Address - Fax:505-268-0820
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM340111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM2670508Medicare PIN