LAKESHORE CHIROPRACTIC AND SPORTS REHABILITATION PLLC (NPI# 1184881344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184881344 |
| Entity Type | Organization |
| Organization Name | LAKESHORE CHIROPRACTIC AND SPORTS REHABILITATION PLLC |
| Other Organization Name | RANDALL CHIROPRACTIC CLINIC |
| Practice Address |
1302 Bridge St Charlevoix MI 49720-1608 |
| Practice Telephone | 2312370665 |
| Practice Fax Number | 2312370672 |
| Mailing Telephone | 2312370665 |
| Mailing Fax Number | 2312370672 |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2018-10-10 |
| Authorized Official Name | DR. AARON WILKIN (OWNER) |
| Authorized Official Telephone | 2312370665 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 2301004616 | MI | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS | 950A550050 | 01 |
| MI | 1408604 | 05 | |
| MI | BCBSM OF MICHIGAN | 950A510420 | 01 |
| Other Name | Type Code |
|---|---|
| Randall Chiropractic Clinic | Doing Business As Name - Organization |
| Street Address |
1302 BRIDGE ST |
| City | CHARLEVOIX |
| State | MI |
| Zip Code | 49720-1608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932257003 | Rick Alan Randall | Chiropractor | 1302 Bridge St, Charlevoix, MI 49720-1608 | 2007-01-08 |
| 1801287222 | Brandon Weaver | Chiropractor | 1302 Bridge St, Charlevoix, MI 49720-1608 | 2015-02-06 |
| 1972790525 | Aaron Douglas Wilkin | Chiropractor | 1302 Bridge St, Charlevoix, MI 49720-1608 | 2007-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477488 | Munson Healthcare Charlevoix Hospital | Urology | 11695 Park Ave, Suite A, Charlevoix, MI 49720 | 2020-11-06 |
| 1215587498 | Amanda Evans | Dietitian, Registered | 09210 North Pointe Woods Drive, Charlevoix, MI 49720 | 2019-09-18 |
| 1508229980 | Charlevoix Physicians Clinic | Specialist | 14709 W. Upright, Charlevoix, MI 49720 | 2016-04-01 |
| 1881014348 | Tracy Skinner | Social Worker | 220 W. Garfield Ave, Charlevoix, MI 49720 | 2014-04-23 |
| 1720414097 | Jennifer Jean Swenor | Occupational Therapist | 10270 Burnett Rd, Charlevoix, MI 49720 | 2013-09-18 |
| 1801171863 | Leslie Lukins | Pharmacist | 1500 Bridge Street, Charlevoix, MI 49720 | 2011-10-20 |
| 1164670949 | Northwest Michigan Community Health Agency | Hospice Care, Community Based | 220 W Garfield Street, Charlevoix, MI 49720 | 2008-09-04 |
| 1275722191 | Robert Dennis Cook | Pharmacist | 301 Bridge Street, Charlevoix, MI 49720 | 2007-10-16 |
| 1629191648 | Susan Mary Killam | Nurse Practitioner | Northwest Michigan Community Health Agency, 220 W. Garfield Street, Charlevoix, MI 49720 | 2007-04-06 |
| 1851410153 | Joelle M Beaudoin | Specialist/Technologist | 06510 M-66 N, Charlevoix, MI 49720 | 2007-03-28 |
| Find all providers in zip 49720 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982802161 | Mcfadden Chiropractic Clinic Inc | Chiropractor | 12900 Us Highway 31 N, Suite G H, Charlevoix, MI 49720-1530 | 2007-07-10 |
| 1932257003 | Rick Alan Randall | Chiropractor | 1302 Bridge St, Charlevoix, MI 49720-1608 | 2007-01-08 |
| 1891720215 | Brian Paul Mcfadden | Chiropractor | 12900 Us 31 North, Suite G H, Charlevoix, MI 49720 | 2006-07-12 |
| 1912930553 | Jeffrey Bernard Ricks | Chiropractor | 1422 Bridge St, Charlevoix, MI 49720-1610 | 2006-07-08 |
| 1295115558 | Ricks Mcclure Chiropractic | Chiropractor | 1422 Bridge St, Charlevoix, MI 49720-1610 | 2015-06-02 |
| 1801287222 | Brandon Weaver | Chiropractor | 1302 Bridge St, Charlevoix, MI 49720-1608 | 2015-02-06 |
| 1265665129 | Kristen Lee Mcclure | Chiropractor | 1422 Bridge St, Charlevoix, MI 49720-1610 | 2009-08-26 |
| 1972790525 | Aaron Douglas Wilkin | Chiropractor | 1302 Bridge St, Charlevoix, MI 49720-1608 | 2007-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548860240 | Moriah K Severance | Chiropractor | 2449 W Kimmel Rd, Jackson, MI 49201-9783 | 2020-10-30 |
| 1760082465 | David Scott Severance | Chiropractor | 11720 Tompkins Rd, Rives Junction, MI 49277-9629 | 2020-10-30 |
| 1760082705 | Kelly Chiropractic Clinic, LLC | Chiropractor | 3179 12 Mile Rd, Berkley, MI 48072-1339 | 2020-10-29 |
| 1619584273 | Sydnee Laree Rutledge | Chiropractor | 3634 Mccain Rd Ste 7, Jackson, MI 49203-2576 | 2020-09-28 |
| 1790391860 | Ferras Dassouki | Chiropractor | 1126 Hunter Ct, Milford, MI 48381-3180 | 2020-09-23 |
| 1811503972 | Nicholas Heiserman | Chiropractor | 498 E Monroe St, Dundee, MI 48131-1321 | 2020-09-23 |
| 1114532835 | Pro-active Chiropractic Wellness of Grand Rapids | Chiropractor | 4270 Plainfield Ave Ne # E, Grand Rapids, MI 49525-1603 | 2020-09-10 |
| 1215540463 | Lake State Chiropractic Pllc | Chiropractor | 2155 84th St Sw Ste 4, Byron Center, MI 49315-8259 | 2020-08-27 |
| 1609488402 | Primrose Family Chiropractic and Wellness Center | Chiropractor | 25900 Greenfield Rd Suite 252, Oak Park, MI 48237-1297 | 2020-08-21 |
| 1780295063 | Wilhelm Family Chiropractic and Massage Pllc | Chiropractor | 23200 Pontiac Trl, South Lyon, MI 48178-1983 | 2020-08-11 |
| Find all providers with the same taxonomy | ||||
| City | CHARLEVOIX |
| Zip Code | 49720 |
Please comment or provide details below to improve the information on LAKESHORE CHIROPRACTIC AND SPORTS REHABILITATION PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.