Provider Demographics
NPI:1134264252
Name:FAIR, LETHA ARENCHILD (DC)
Entity type:Individual
Prefix:DR
First Name:LETHA
Middle Name:ARENCHILD
Last Name:FAIR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2084 MOONSTONE CIR
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-4345
Mailing Address - Country:US
Mailing Address - Phone:916-690-6763
Mailing Address - Fax:916-933-5148
Practice Address - Street 1:2084 MOONSTONE CIR
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-4345
Practice Address - Country:US
Practice Address - Phone:916-690-6763
Practice Address - Fax:916-933-5148
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22932 CA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor