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Individual

LEE MICHAEL LOFGREN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
160 S 4TH ST, LANDER, WY 82520-3116
(307) 332-6148
(307) 332-5157
Mailing address
160 S 4TH ST, LANDER, WY 82520-3116
(307) 332-6148
(307) 332-5157

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
490
WY
111N00000X
Chiropractor
557
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
W307327
MEDICARE PROVIDER #
WY
Enumeration date
05/13/2010
Last updated
05/13/2010
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