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Organization
LAKESIDE CHIROPRACTIC LLC
Active
Organization
LAKESIDE CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNOR THOMAS WEARS DC (OWNER)
(651) 583-8971
Entity
Organization
Contact information
Practice address
6885 BOUDIN ST NE STE 200, PRIOR LAKE, MN 55372-2091
(651) 583-8971
(612) 712-3023
Mailing address
20723 HAMPSHIRE CIR, LAKEVILLE, MN 55044-4669
(651) 583-8971
(612) 712-3023
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
06/14/2024
Last updated
06/14/2024
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