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Organization

LASTINE CHIROPRACTIC PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KRIS BLAINE LASTINE DC (DOCTOR/OWNER)
(507) 537-1475
Entity
Organization

Contact information

Practice address
1411 E COLLEGE DR, STE 4, MARSHALL, MN 56258-2086
(507) 537-1475
(507) 537-9498
Mailing address
1411 E COLLEGE DR, STE 4, MARSHALL, MN 56258-2086
(507) 537-1475
(507) 537-9498

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2194
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
891228900
MN
Enumeration date
10/11/2011
Last updated
10/11/2011
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