Organization
LAKESHORE CHIROPRACTIC AND SPORTS REHABILITATION PLLC
Active
Other names
Randall Chiropractic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AARON WILKIN DC (OWNER)
(231) 237-0665
Entity
Organization
Contact information
Practice address
1302 BRIDGE ST, CHARLEVOIX, MI 49720-1608
(231) 237-0665
(231) 237-0672
Mailing address
1302 BRIDGE ST, CHARLEVOIX, MI 49720-1608
(231) 237-0665
(231) 237-0672
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301004616
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1408604
—
MI
01
—
950A510420
BCBSM OF MICHIGAN
MI
01
—
950A550050
BCBS
MI
Enumeration date
05/16/2008
Last updated
10/10/2018
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