Organization
ISLAND CHIROPRACTIC AND ACUPUNCTURE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOEY LEE LASKE D.C. (PRESIDENT/CHIROPRACTOR)
(956) 761-6006
Entity
Organization
Contact information
Practice address
3311 PADRE BLVD, SUITE B, SOUTH PADRE ISLAND, TX 78597-7048
(956) 761-6006
(956) 761-6002
Mailing address
3311 PADRE BLVD, SUITE B, SOUTH PADRE ISLAND, TX 78597-7048
(956) 761-6006
(956) 761-6002
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
8835
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
606681
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/18/2007
Last updated
12/18/2007
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