Organization
LAKESHORE CHIROPRATIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL HY MIONIE D.C. (OWNER)
(770) 540-0583
Entity
Organization
Contact information
Practice address
275 PEARL NIX PKWY, SUITE 1, GAINESVILLE, GA 30501-3590
(770) 532-8200
(770) 532-9222
Mailing address
275 PEARL NIX PKWY, SUITE 1, GAINESVILLE, GA 30501-3590
(770) 532-8200
(770) 532-9222
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR005004
GA
Other
Enumeration date
11/14/2011
Last updated
11/14/2011
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