NPI 1144063447

Lakeside Chiropractic LLC

Organisation Chiropractor Prior Lake, MN

Practice location

Address: 6885 Boudin St NE STE 200, Prior Lake, MN 55372-2091
Phone: (651) 583-8971
Fax: (612) 712-3023
Mailing address: 20723 Hampshire Cir, Lakeville, MN 55044-4669

Authorised official

Name: Connor Thomas Wears
Title: Owner
Phone: (651) 583-8971

Registered specialties

Chiropractor Primary

Chiropractic Providers Taxonomy 111N00000X

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Registry record

NPI: 1144063447
Entity type: Organization
NPI issued: 14 Jun 2024
Record last updated: 14 Jun 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.