Healthcare Provider Details

I. General information

NPI: 1326305111
Provider Name (Legal Business Name): LIFESTYLE CHIROPRACTIC P. C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2012
Last Update Date: 03/25/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5372 FALLOWATER LN STE B
CAVE SPRING VA
24018-0909
US

IV. Provider business mailing address

5372 FALLOWATER LN STE B
CAVE SPRING VA
24018-0909
US

V. Phone/Fax

Practice location:
  • Phone: 540-725-9501
  • Fax:
Mailing address:
  • Phone: 540-725-9501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER C LAURIA
Title or Position: OWNER/PROVIDER
Credential:
Phone: 540-725-9501