| NPI | 1811268667 |
|---|---|
| Doing Business As | LAKESIDE CHIROPRACTIC WELLNESS CENTER, LLC |
| Entity Type | Organization |
| Authorized Contact | DALE ENOCH CALLAWAY Chiropractor/Owner 678-401-8207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA CHIR008802) |
| Enumeration Date | 2012-01-24 |
| Last Update Date | 2012-04-27 |