Organization
LAKE CRYSTAL CHIROPRACTIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM GRIMES DC (OWNER)
(612) 360-3483
Entity
Organization
Contact information
Practice address
201 N MAIN ST, LAKE CRYSTAL, MN 56055-2112
(612) 360-3483
Mailing address
201 N MAIN ST, LAKE CRYSTAL, MN 56055-2112
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
11/20/2018
Last updated
09/13/2019
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