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General NPI Number Information
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NPI Number | 1649557257
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Entity Type | Organization
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Legal Business Name | THE LAKES COMMUNITY HEALTH CENTER, INC
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Dates
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Enumeration Date | 11/10/2011
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Last Update Date | 08/05/2021
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Provider Practice Location Address
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Address Line | 7665 US HIGHWAY 2
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City | IRON RIVER
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State | WI
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Zip | 54847-4690
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Country | US
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Telephone | 715-372-5001
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Fax | 715-372-5001
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Provider Business Mailing Address
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Address Line | 7665 US HIGHWAY 2
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City | IRON RIVER
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State | WI
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Zip | 54847-4690
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Country | US
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Telephone | 715-372-5001
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Fax | 715-372-5067
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Authorized Official
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Title or Position | CEO
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Name | REBA RICE
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Credential |
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Telephone | 715-372-5001
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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 | 4768-012
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License Number State | WI
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