Lake And Leaf Chiropractic Pllc is a medicare enrolled primary clinic (Clinic/center) in Lindstrom, Minnesota. The current practice location for Lake And Leaf Chiropractic Pllc is 12818 Lake Blvd, Lindstrom, Minnesota. For appointments, you can reach them via phone at
(651) 257-2300. The mailing address for Lake And Leaf Chiropractic Pllc is 12818 Lake Blvd, Lindstrom, Minnesota and phone number is (651) 257-2300.
Lake And Leaf Chiropractic Pllc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its
NPI number is 1669193793. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(651) 257-2300.
Primary Care Clinic Profile
| Full Name | Lake And Leaf Chiropractic Pllc |
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| Speciality | Clinic/Center |
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| Location | 12818 Lake Blvd, Lindstrom, Minnesota |
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| Authorized Official Name and Position | Eric Jon Gormanson (OWNER) |
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| Authorized Official Contact | 6512572300 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Lake And Leaf Chiropractic Pllc
12818 Lake Blvd
Lindstrom
MN 55045
Ph: (651) 257-2300 | Lake And Leaf Chiropractic Pllc
12818 Lake Blvd
Lindstrom
MN 55045
Ph: (651) 257-2300 |
NPI Details:
| NPI Number | 1669193793 |
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| Provider Enumeration Date | 09/07/2022 |
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| Last Update Date | 12/13/2022 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 5496125973 |
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| Medicare Enrollment ID | O20221227000988 |
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Medical Identifiers
Medical identifiers for Lake And Leaf Chiropractic Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1669193793 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Lake And Leaf Chiropractic Pllc acts as a billing entity for following providers:
| Provider Name | Eric Gormanson |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1023157831
PECOS PAC ID: 6608970629
Enrollment ID: I20221227001102 |
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