Organization
LAKESIDE CHIROPRACTIC CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN KINKADE ANTLEY D.C. (OWNER)
(406) 844-2151
Entity
Organization
Contact information
Practice address
7176 HWY 93 S, LAKESIDE, MT 59922
(406) 844-2151
Mailing address
PO BOX 648, LAKESIDE, MT 59922-0648
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHI 954
MT
Other
Enumeration date
01/06/2010
Last updated
03/16/2011
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