| NPI | 1891430583 |
|---|---|
| Doing Business As | LAKESIDE NORTH |
| Entity Type | Organization |
| Authorized Contact | DAVID CLAY CAMPBELL President 256-571-8460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2022-04-28 |
| Last Update Date | 2022-04-28 |