Provider Demographics
NPI:1730226903
Name:LENTFER, J NICOLE (LAC)
Entity type:Individual
Prefix:
First Name:J
Middle Name:NICOLE
Last Name:LENTFER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4701 WEST GATE BLVD
Mailing Address - Street 2:SUITE B202
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745
Mailing Address - Country:US
Mailing Address - Phone:512-892-3366
Mailing Address - Fax:512-892-3384
Practice Address - Street 1:4701 WEST GATE BLVD
Practice Address - Street 2:SUITE B202
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745
Practice Address - Country:US
Practice Address - Phone:512-892-3366
Practice Address - Fax:512-892-3384
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAC00705171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist