Organization
LISBON CHIROPRACTIC CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COREY CLARK WILLIAMS DC (OWNER)
(701) 683-4582
Entity
Organization
Contact information
Practice address
906 MAIN ST, LISBON, ND 58054-4333
(701) 683-4582
(701) 683-5814
Mailing address
PO BOX 255, LISBON, ND 58054-0255
(701) 683-4582
(701) 683-5814
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
562
ND
111N00000X
Chiropractor
640
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11490
—
ND
01
—
31B45LI
BLUE SELECT GROUP NUMBER
—
Enumeration date
08/23/2005
Last updated
09/25/2007
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