Individual
ALA LORA LYSYK SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
104 W LINCOLN AVE, FERGUS FALLS, MN 56537-2123
(218) 736-4113
(218) 998-4337
Mailing address
104 W LINCOLN AVE, FERGUS FALLS, MN 56537-2123
(218) 736-4113
(218) 998-4337
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3238
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
231892
CHIROCARE
MN
01
—
350046096
RAILROAD MEDICARE
MN
01
—
4C740LY
BLUE CROSS/BLUE SHIELD
MN
05
—
804023100
—
MN
Enumeration date
09/30/2005
Last updated
07/15/2010
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