Organization
LAKEVILLE COMMUNITY CHIROPRACTIC
Active
Parent organization
LAKEVILLE COMMUNITY CHIROPRACTIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAKEVILLE COMMUNITY CHIROPRACTIC
Authorized official
DR. WILLIAM DANIEL GRIMES D.C. (OWNER)
(612) 360-3483
Entity
Organization
Contact information
Practice address
17305 CEDAR AVE S, SUITE 250, LAKEVILLE, MN 55044-3901
(612) 360-3483
Mailing address
15677 HAYES TRL, APPLE VALLEY, MN 55124-7137
(952) 432-2313
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5097
MN
Other
Enumeration date
09/16/2008
Last updated
09/16/2008
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