Lakeside Chiropractic Clinic,P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301002908 Issued in MI

Legal business name

LAKESIDE CHIROPRACTIC CLINIC,P.C.

Practice address

152 E Saginaw Rd
Suite 7
Sanford, MI 48657-9271

Phone

(989) 687-9299

Fax

(989) 687-6382

NPI assigned

Aug 26, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Ceann Undine Branson, D.C.

Title

Owner

Phone

(989) 687-9299

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1219708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219708800000",
    "number": "1962659417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 E SAGINAW RD",
            "address_2": "SUITE 7",
            "city": "SANFORD",
            "state": "MI",
            "postal_code": "486579271",
            "telephone_number": "989-687-9299",
            "fax_number": "989-687-6382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 E SAGINAW RD",
            "address_2": "SUITE 7",
            "city": "SANFORD",
            "state": "MI",
            "postal_code": "486579271",
            "telephone_number": "989-687-9299",
            "fax_number": "989-687-6382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE CHIROPRACTIC CLINIC,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-26",
        "last_updated": "2008-08-26",
        "status": "A",
        "authorized_official_last_name": "BRANSON",
        "authorized_official_first_name": "CEANN",
        "authorized_official_middle_name": "UNDINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-687-9299",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301002908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; 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.