Provider Demographics
NPI:1467911305
Name:LAKEVIEW CHIROPRACTIC AND WELLNESS PLLC
Entity Type:Organization
Organization Name:LAKEVIEW CHIROPRACTIC AND WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:603-630-3594
Mailing Address - Street 1:290 DANIEL WEBSTER HWY # 2A
Mailing Address - Street 2:
Mailing Address - City:MEREDITH
Mailing Address - State:NH
Mailing Address - Zip Code:03253-5806
Mailing Address - Country:US
Mailing Address - Phone:603-630-3594
Mailing Address - Fax:
Practice Address - Street 1:290 DANIEL WEBSTER HWY # 2A
Practice Address - Street 2:
Practice Address - City:MEREDITH
Practice Address - State:NH
Practice Address - Zip Code:03253-5806
Practice Address - Country:US
Practice Address - Phone:603-630-3594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-19
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty