Provider Demographics
NPI:1033575196
Name:VAIDA CHIROPRACTIC, INC
Entity type:Organization
Organization Name:VAIDA CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:763-355-4188
Mailing Address - Street 1:101 LAKE ST W
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-1576
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 LAKE ST W
Practice Address - Street 2:SUITE 210
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-1576
Practice Address - Country:US
Practice Address - Phone:952-473-1773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5664111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty