Organization
LAKESIDE HOLISTIC HEALTH, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY LEE BAILEY II DC, CAC (OWNER/PARTNER)
(208) 758-0568
Entity
Organization
Contact information
Practice address
518 NORTH 4TH STREET, COEUR D'ALENE, ID 83814
(208) 758-0568
(208) 765-4660
Mailing address
518 NORTH 4TH STREET, COEUR D'ALENE, ID 83814
(208) 758-0568
(208) 765-4660
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CHIA-932
ID
171100000X
Acupuncturist
ACU-148
ID
175F00000X
Naturopath
Primary
NT00001257
WA
Other
Enumeration date
05/29/2012
Last updated
05/29/2012
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