Provider Demographics
NPI:1982806022
Name:LENNOX, NICOLAI (DC)
Entity Type:Individual
Prefix:DR
First Name:NICOLAI
Middle Name:
Last Name:LENNOX
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 1:1125 CAMINO DEL MAR
Mailing Address - Street 2:SUITE C
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-2645
Mailing Address - Country:US
Mailing Address - Phone:858-481-9854
Mailing Address - Fax:858-481-9738
Practice Address - Street 1:1125 CAMINO DEL MAR
Practice Address - Street 2:SUITE C
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-2645
Practice Address - Country:US
Practice Address - Phone:858-481-9854
Practice Address - Fax:858-481-9738
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 11472111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor