Provider Demographics
NPI:1588088041
Name:LANCE, AUDRA (DC)
Entity type:Individual
Prefix:DR
First Name:AUDRA
Middle Name:
Last Name:LANCE
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 1:2580 JORDAN RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37218-3622
Mailing Address - Country:US
Mailing Address - Phone:330-416-5647
Mailing Address - Fax:
Practice Address - Street 1:2580 JORDAN RIDGE DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37218-3622
Practice Address - Country:US
Practice Address - Phone:330-416-5647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2744111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor