Provider Demographics
NPI:1154453892
Name:LAKE POINTE CHIROPRACTIC CENTRE
Entity Type:Organization
Organization Name:LAKE POINTE CHIROPRACTIC CENTRE
Other - Org Name:LAKE POINTE CHIROPRACTIC & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GETZMIER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:612-922-8100
Mailing Address - Street 1:5000 W 36TH ST STE 120
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55416-2758
Mailing Address - Country:US
Mailing Address - Phone:612-922-8100
Mailing Address - Fax:
Practice Address - Street 1:5000 W 36TH ST STE 120
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55416-2758
Practice Address - Country:US
Practice Address - Phone:612-922-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN75250OtherHEALTH PARTNERS
MN18F89LAOtherBCBS MN
MNC03540Medicare ID - Type UnspecifiedMEDICARE