Organization
LAKESIDE CHIROPRACTIC CLINIC PC
Active
Other names
Meridian Chiropractic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFRY S. YODER (PRESIDENT)
(317) 923-4894
Entity
Organization
Contact information
Practice address
2162 N MERIDIAN ST, SUITE C, INDIANAPOLIS, IN 46202-1311
(317) 923-4894
Mailing address
2162 N MERIDIAN ST, SUITE C, INDIANAPOLIS, IN 46202-1311
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
8001769A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200314240A
—
IN
Enumeration date
04/19/2007
Last updated
04/21/2009
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