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Contact Information

LAKESIDE HOLISTIC HEALTH, PLLC
518 NORTH 4TH STREET
COEUR D'ALENE, ID83814
 Phone: 208-758-0568
 Fax: 208-765-4660
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Naturopath

175F00000X
 

Acupuncturist

171100000X
 

Chiropractor

111N00000X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for LAKESIDE HOLISTIC HEALTH, PLLC

NPI # 1669732350
LBN Legal business name LAKESIDE HOLISTIC HEALTH, PLLC
Authorized official JERRY BAILEY - (OWNER/PARTNER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/29/2012
Last updated 05/29/2012 - About 14 years ago
Identifiers
ID License # ACU-148
ID License # CHIA-932
WA License # NT00001257
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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