Individual
DR. LANCE ROBERT SEVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D. C.
Contact information
Practice address
416 W GOODWIN ST, PRESCOTT, AZ 86303-3737
(928) 778-7062
(928) 775-2385
Mailing address
4878 N SOCORRO DR, PRESCOTT VALLEY, AZ 86314-7136
(928) 778-7062
(928) 775-2385
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4804
AZ
Other
Enumeration date
03/07/2006
Last updated
07/08/2007
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