Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 08001035A | IN |
NPI | 1073586467 |
---|---|
Provider Name | Dr. Marian F. Klaes-Lanham |
First Address | Seymour, IN 47274-0747 |
Second Address | Seymour, IN 47274-2224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 28/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1033380A | (05) | IN |
T34723 | (02) | IN |