Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | DCP00460 | RI |
NPI | 1134225113 |
---|---|
Provider Name | Dr. Dennis James Lanni |
First Address | Providence, RI 02908-2105 |
Second Address | Providence, RI 02908-2105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 18/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U88887 | (02) | RI |