Organization
LACKMAN CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZARA LACKMAN D.C., D.I.C.C.P. (CHIROPRACTOR, OWNER)
(715) 571-2702
Entity
Organization
Contact information
Practice address
4001 RIB MOUNTAIN DR, WAUSAU, WI 54401-7445
(715) 571-2702
Mailing address
4001 RIB MOUNTAIN DR, WAUSAU, WI 54401-7445
(715) 571-2702
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
3393-012
WI
111NP0017X
Pediatric Chiropractor
Primary
3393-012
WI
Other
Enumeration date
07/22/2010
Last updated
07/22/2010
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