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 provides Chiropractor services 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

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