Organization
LAKE AND LEAF CHIROPRACTIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC JON GORMANSON DC (OWNER)
(651) 257-2300
Entity
Organization
Contact information
Practice address
12818 LAKE BLVD, LINDSTROM, MN 55045
(651) 257-2300
(651) 257-2333
Mailing address
12818 LAKE BLVD, LINDSTROM, MN 55045
(651) 257-2300
(651) 257-2333
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/07/2022
Last updated
12/13/2022
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