Organization
COUNTRYSIDE FAMILY CHIROPRACTIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODIE MARIE LASKY (CHIROPRACTOR/OWNER)
(585) 905-0036
Entity
Organization
Contact information
Practice address
4385 RECREATION DR, CANANDAIGUA, NY 14424-2232
(585) 449-9874
Mailing address
4385 RECREATION DR, CANANDAIGUA, NY 14424-2232
(585) 905-0036
(800) 974-2190
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013371
STATE LICENSE
NY
Enumeration date
11/19/2020
Last updated
02/10/2026
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