Provider Demographics
NPI:1871575522
Name:LICHTER, ALAN JAY (DC)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:JAY
Last Name:LICHTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1522 K ST NW
Mailing Address - Street 2:SUITE 1036
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-1202
Mailing Address - Country:US
Mailing Address - Phone:202-682-9222
Mailing Address - Fax:202-682-1110
Practice Address - Street 1:1522 K ST NW
Practice Address - Street 2:SUITE1036
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-1202
Practice Address - Country:US
Practice Address - Phone:202-682-9222
Practice Address - Fax:202-682-1110
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCCH14095111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T30794Medicare UPIN