Organization
LAKESIDE CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NUNZIO P PAGANO SR. DC (SOLE MEMBER)
(304) 619-1912
Entity
Organization
Contact information
Practice address
245 CAMPSITE ROAD, MOUNT NEBO, WV 26679
(304) 619-1912
(304) 872-4143
Mailing address
PO BOX 353, MOUNT NEBO, WV 26679-0353
(304) 619-1912
(304) 872-4143
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
10/06/2009
Last updated
10/06/2009
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