Provider Demographics
NPI:1538592555
Name:LIGHTHOUSE CHIROPRACTIC TOLEDO LLC
Entity type:Organization
Organization Name:LIGHTHOUSE CHIROPRACTIC TOLEDO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEANA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAJINESS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-318-5005
Mailing Address - Street 1:2477 SHORELAND AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43611-1567
Mailing Address - Country:US
Mailing Address - Phone:248-318-5005
Mailing Address - Fax:
Practice Address - Street 1:2477 SHORELAND AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43611-1567
Practice Address - Country:US
Practice Address - Phone:248-318-5005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4346111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty