| Lake and Leaf Chiropractic PLLC | |
|
12818 Lake Blvd Lindstrom MN 55045 | |
| (651) 257-2300 | |
| (651) 257-2333 |
| Full Name | Lake and Leaf Chiropractic PLLC |
|---|---|
| Speciality | Clinic/center |
| Location | 12818 Lake Blvd, Lindstrom, Minnesota |
| Authorized Official Name and Position | Eric Jon Gormanson (OWNER) |
| Authorized Official Contact | 6512572300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake and Leaf Chiropractic PLLC 12818 Lake Blvd Lindstrom MN 55045 Ph: (651) 257-2300 | Lake and Leaf Chiropractic PLLC 12818 Lake Blvd Lindstrom MN 55045 Ph: (651) 257-2300 |
| NPI Number | 1669193793 |
|---|---|
| Provider Enumeration Date | 09/07/2022 |
| Last Update Date | 12/13/2022 |
| Certification Date | 12/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669193793 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
Lindstrom Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12375 Lindstrom Ln, Lindstrom, MN 55045 Phone: 651-400-2240 Fax: 715-483-0507 |