Organization
GREAT LAKES FAMILY CHIROPRACTIC CENTER,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYNNE E HULSE (OFFICE MANAGER)
(814) 824-6442
Entity
Organization
Contact information
Practice address
1009 E 38TH ST, ERIE, PA 16504-1843
(814) 824-6442
(814) 824-4007
Mailing address
1009 E 38TH ST, ERIE, PA 16504-1843
(814) 824-6442
(814) 824-4007
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC005135L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1394234
BLUE CROSS/BLUE SHIELD
PA
Enumeration date
02/15/2008
Last updated
07/08/2008
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