Organization
LAKESIDE CHIROPRACTIC PC
Active
Organization
LAKESIDE CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD ALBERT BOATRIGHT D.C. (PRESIDENT)
(928) 532-1225
Entity
Organization
Contact information
Practice address
1640 E OLIVER PL, SHOW LOW, AZ 85901-6117
(928) 532-1225
(928) 532-2276
Mailing address
PO BOX 3330, PINETOP, AZ 85935-3330
(928) 532-1225
(928) 532-2276
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
5129
AZ
Other
Enumeration date
01/10/2008
Last updated
03/07/2008
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