Provider Demographics
NPI:1700188059
Name:LINDHOLM CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:LINDHOLM CHIROPRACTIC, PC
Other - Org Name:NATURAL HEALTH FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:LINDHOLM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:574-262-4402
Mailing Address - Street 1:601 E BRISTOL ST
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46514-3418
Mailing Address - Country:US
Mailing Address - Phone:574-262-4402
Mailing Address - Fax:574-264-0778
Practice Address - Street 1:601 E BRISTOL ST
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-3418
Practice Address - Country:US
Practice Address - Phone:574-262-4402
Practice Address - Fax:574-264-0778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty