Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 2923 | OH |
NPI | 1114088655 |
---|---|
Provider Name | Dr. Kevin David Lehane |
First Address | Pelham, NH 03076-3419 |
Second Address | Pelham, NH 03076-3419 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2179477 | (05) | OH |