| Lakeland Chiropractic Clinic | |
|
14822 N Highway 41 Rathdrum ID 83858-8461 | |
| (208) 687-7029 | |
| Not Available |
| Full Name | Lakeland Chiropractic Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 14822 N Highway 41, Rathdrum, Idaho |
| Authorized Official Name and Position | Jani Sue Hall (OFFICE MANAGER) |
| Authorized Official Contact | 2086877029 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeland Chiropractic Clinic 14822 N Highway 41 Rathdrum ID 83858-8461 Ph: (208) 687-7029 | Lakeland Chiropractic Clinic 14822 N Highway 41 Rathdrum ID 83858-8461 Ph: (208) 687-7029 |
| NPI Number | 1821526260 |
|---|---|
| Provider Enumeration Date | 05/30/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 5395017958 |
|---|---|
| Medicare Enrollment ID | O20170817001522 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821526260 | NPI | - | NPPES |
| 1881705366 | Other | MEDICAID, BLUE SHIELD OF IDAHO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | CHIA-924 (Idaho) | Primary |
| Provider Name | Steven B Hall |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1881705366 PECOS PAC ID: 1658548375 Enrollment ID: I20120120000749 |
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