Healthcare Provider Details

I. General information

NPI: 1083913602
Provider Name (Legal Business Name): NEW LIFE FAMILY CHIROPRACTIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2011
Last Update Date: 06/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 HIGHWAY 31 S SUITE 104
DECATUR AL
35603-1510
US

IV. Provider business mailing address

2828 HIGHWAY 31 S SUITE 104
DECATUR AL
35603-1510
US

V. Phone/Fax

Practice location:
  • Phone: 256-301-0110
  • Fax: 256-301-0116
Mailing address:
  • Phone: 256-301-0110
  • Fax: 256-301-0116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2214
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number2214
License Number StateAL

VIII. Authorized Official

Name: DR. MISTY MARIE BROWNING
Title or Position: OWNER/DOCTOR
Credential: DC
Phone: 256-301-0110