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General NPI Number Information
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NPI Number | 1427589332
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Entity Type | Organization
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Legal Business Name | HEALING LAKES CHIROPRACTIC LLC
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Dates
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Enumeration Date | 03/22/2017
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 635 MAIN ST SUITE I
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City | LACONIA
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State | NH
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Zip | 03246-3415
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Country | US
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Telephone | 603-965-3642
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Fax |
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Provider Business Mailing Address
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Address Line | 635 MAIN ST SUITE I
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City | LACONIA
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State | NH
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Zip | 03246-3415
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Country | US
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Telephone | 603-965-3642
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | VALERIE LUNNON-DUPONT
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Credential | DC
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Telephone | 603-965-3642
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 922
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License Number State | NH
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