| Lyndonville Family Chiropractic, Inc. | |
|
11 Hill St, Lyndonville, VT 05851-8911 | |
| (802) 626-5866 | |
| (802) 626-0980 |
| Full Name | Lyndonville Family Chiropractic, Inc. |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 11 Hill St, Lyndonville, Vermont |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326254657 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 006-0001143 (Vermont) | Primary |
| Provider Name | Karson Ellsworth Clark |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1942326822 PECOS PAC ID: 5698737252 Enrollment ID: I20041027000568 |
| Provider Name | Teri R Dodge |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1770742942 PECOS PAC ID: 6709940380 Enrollment ID: I20090126000687 |
| Provider Name | Stacey Ann Clark |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1699891580 PECOS PAC ID: 4183688815 Enrollment ID: I20121204000007 |
| Mailing Address | Practice Location Address |
|---|---|
| Lyndonville Family Chiropractic, Inc. 11 Hill St, Lyndonville, VT 05851-8911 Ph: (802) 626-5866 | Lyndonville Family Chiropractic, Inc. 11 Hill St, Lyndonville, VT 05851-8911 Ph: (802) 626-5866 |
Dr. Stacey Ann Clark, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 11 Hill St, Lyndonville, VT 05851 Phone: 802-626-5866 Fax: 802-626-0980 | |
Dr. Karson Ellsworth Clark Jr., D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 11 Hill St, Lyndonville, VT 05851 Phone: 802-626-5866 Fax: 802-626-0980 |