Lakes Family Chiropractic PLLC
Organization Active NPI Chiropractor · Glenwood, MN
NPI 1306467907 · NPPES record last updated Apr 16, 2021
Key facts
- NPI
- 1306467907
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- LAKES FAMILY CHIROPRACTIC PLLC
- Practice address
- 16 Minnesota Ave W Ste 100
Glenwood, MN 56334-1558 - Phone
- (320) 634-3000
- NPI assigned
- May 5, 2020
- Organization subpart
- No
Authorized official
- Name
- Adam Daniel Loe, DC
- Title
- Owner/Chiropractic
- Phone
- (320) 634-3000
Practitioners 1
-
Adam Loe, D.C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210312000742 | MN | Part B Supplier - Clinic/Group Practice | 8224443239 |
Receives reassigned benefits from 1 practitioner Practice locations: Glenwood, MN |
National Provider Directory
Locations
16 Minnesota Ave W
Glenwood, MN 56334
16 Minnesota Ave W
Ste 100
Glenwood, MN 56334
Phone (320) 226-7002
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
16 Minnesota Ave W Ste 100
Glenwood, MN 56334-1558
Mailing address
16 Minnesota Ave W Ste 100
Glenwood, MN 56334-1558
Phone (320) 226-7002
Other providers in Glenwood, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 16, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.