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Organization
LIGHTHOUSE CHIROPRACTIC HEALTH CENTER, INC
Active
Organization
LIGHTHOUSE CHIROPRACTIC HEALTH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN O ENG DC (OWNER)
(763) 441-1701
Entity
Organization
Contact information
Practice address
710 DODGE AVE NW, SUITE C, ELK RIVER, MN 55330-2019
(763) 441-1701
(763) 441-5348
Mailing address
710 DODGE AVE NW, SUITE C, ELK RIVER, MN 55330-2019
(763) 441-1701
(763) 441-5348
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3331
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5C580ST
BLUE CROSS BLUE SHIELD
MN
05
—
6855253-00
—
MN
Enumeration date
11/30/2006
Last updated
07/24/2012
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