| Lakeside Chiropractic Pc | |
|
1640 E Oliver Pl Show Low AZ 85901-6117 | |
| (928) 532-1225 | |
| (928) 532-2276 |
| Full Name | Lakeside Chiropractic Pc |
|---|---|
| Speciality | Clinic/center |
| Location | 1640 E Oliver Pl, Show Low, Arizona |
| Authorized Official Name and Position | Richard Albert Boatright (PRESIDENT) |
| Authorized Official Contact | 9285321225 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Chiropractic Pc Po Box 3330 Pinetop AZ 85935-3330 Ph: (928) 532-1225 | Lakeside Chiropractic Pc 1640 E Oliver Pl Show Low AZ 85901-6117 Ph: (928) 532-1225 |
| NPI Number | 1417133265 |
|---|---|
| Provider Enumeration Date | 01/10/2008 |
| Last Update Date | 03/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417133265 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 5129 (Arizona) | Primary |
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