Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Northern Lakes Chiropractic Clinic, PC

Organization Chiropractor · NPI 1710156443

Northern Lakes Chiropractic Clinic, PC is a Chiropractor in Ponderay, Idaho. Licensed in Idaho. Registered with an NPI since 2008.

Licensed in
ID
In the registry since
2008
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

30544 Highway 200 Ste 330
Ponderay, ID 83852-5005
Phone: (208) 265-1900
Fax: (208) 227-8313
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Chiropractor (primary) Taxonomy 111N00000X · Licence CHIA-1250 (ID)

Record details

NPI number1710156443
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ryan Leisy — Ceo · (208) 265-1900
NPI enumeratedFebruary 27, 2008
Last updated in NPPESMarch 29, 2018
Mailing address30544 Highway 200 Ste 330, Ponderay, ID 83852-5005

Other providers in Ponderay