Provider Demographics
NPI:1073609939
Name:DANZEY, LAMESA MONIQUE (DC)
Entity type:Individual
Prefix:
First Name:LAMESA
Middle Name:MONIQUE
Last Name:DANZEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 W MAIN ST STE 5
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-1360
Mailing Address - Country:US
Mailing Address - Phone:334-780-1060
Mailing Address - Fax:334-780-1068
Practice Address - Street 1:1801 W MAIN ST STE 5
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-1360
Practice Address - Country:US
Practice Address - Phone:334-780-1060
Practice Address - Fax:334-780-1068
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008494111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI371432071Medicare UPIN
MI0N92950Medicare ID - Type Unspecified