Lakes Area Chiropractic Clinic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3423 Issued in MN

Legal business name

LAKES AREA CHIROPRACTIC CLINIC LLC

Practice address

12814 Lake Blvd
Lindstrom, MN 55045-9345

Phone

(651) 257-3900

Fax

(651) 257-3932

NPI assigned

May 26, 2009

Last updated

Nov 11, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Erik J Peterson, D.C.

Title

Chiropractor

Phone

(651) 257-3900

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257897600000",
    "number": "1356576060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12814 LAKE BLVD",
            "city": "LINDSTROM",
            "state": "MN",
            "postal_code": "550459345",
            "telephone_number": "651-257-3900",
            "fax_number": "651-257-3932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12814 LAKE BLVD",
            "city": "LINDSTROM",
            "state": "MN",
            "postal_code": "550459345",
            "telephone_number": "651-257-3900",
            "fax_number": "651-257-3932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKES AREA CHIROPRACTIC CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-26",
        "last_updated": "2009-11-11",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "ERIK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "651-257-3900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virginia Johnson, RPT
• Kimberley M Johnson DC
• Varghese Daniel Kottarathil
• Lake and Leaf Chiropractic PLLC
• Lake Optometric Vision PA (lindstrom optical)
• Lindstrom Chiropractic Center, P.a.
• Lindstrom Family Dentistry LLC
• Kathryn Ann Long, RN, L.AC
• Vernon Bruce Lovdokken, OD
• Marisha Love

• Chiropractor in Lindstrom, MN
• Providers in Lindstrom, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.