Provider Demographics
NPI:1265596498
Name:LENZ, LEIGH F (DC)
Entity type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:F
Last Name:LENZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:LEIGH
Other - Last Name:FRISBEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:155 ALTA VISTA RD STE B
Mailing Address - Street 2:
Mailing Address - City:EAGLE POINT
Mailing Address - State:OR
Mailing Address - Zip Code:97524-9735
Mailing Address - Country:US
Mailing Address - Phone:541-879-3443
Mailing Address - Fax:541-879-3445
Practice Address - Street 1:155 ALTA VISTA RD STE B
Practice Address - Street 2:
Practice Address - City:EAGLE POINT
Practice Address - State:OR
Practice Address - Zip Code:97524-9735
Practice Address - Country:US
Practice Address - Phone:541-879-3443
Practice Address - Fax:541-879-3445
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27 3492111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR233000Medicaid
OR233000Medicaid
V00903Medicare UPIN