Provider Demographics
NPI:1427589332
Name:HEALING LAKES CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:HEALING LAKES CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNNON-DUPONT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:603-965-3642
Mailing Address - Street 1:635 MAIN ST
Mailing Address - Street 2:SUITE I
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-3415
Mailing Address - Country:US
Mailing Address - Phone:603-965-3642
Mailing Address - Fax:
Practice Address - Street 1:635 MAIN ST
Practice Address - Street 2:SUITE I
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-3415
Practice Address - Country:US
Practice Address - Phone:603-965-3642
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-22
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH922111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty