Organization
LAKESIDE CHIROPRACTIC SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW L WEAKLEND D.C. (SOLE MBR)
(402) 697-7463
Entity
Organization
Contact information
Practice address
18017 OAK ST STE A, OMAHA, NE 68130-6024
(402) 697-7463
(402) 892-1056
Mailing address
18017 OAK ST STE A, OMAHA, NE 68130-6024
(402) 697-7463
(402) 614-5174
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1351
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09543
BLUE CROSS BLUE SHIELD OF NEBRASKA
NE
05
—
10025234000
—
NE
Enumeration date
11/07/2013
Last updated
09/22/2022
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