# LAKESHORE CHIROPRACTIC WELLNESS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396525002
- **Authorized official:** DR. TIMOTHY ALAN SMITH DC (OWNER - CHIROPRACTOR)
- **Authorized official phone:** (716) 208-6039

## Contact information

- **Practice address:** 6778 ERIE RD, DERBY, NY 14047-9672
- **Practice address phone:** (716) 947-5106
- **Practice address fax:** (716) 947-9329
- **Mailing address:** 4711 CLARK ST, HAMBURG, NY 14075-3905
- **Mailing address phone:** (716) 947-5106
- **Mailing address fax:** (716) 947-9329

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | — | Yes |

## Other

- **Enumeration date:** 10/02/2023
- **Last updated:** 02/23/2024