Healthcare Provider Details

I. General information

NPI: 1407044811
Provider Name (Legal Business Name): LIFEFORCE CHIROPRACTIC, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2007
Last Update Date: 07/16/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3204 WASHINGTON AVE
RACINE WI
53405-3037
US

IV. Provider business mailing address

1117 ARTHUR AVE
RACINE WI
53405-2902
US

V. Phone/Fax

Practice location:
  • Phone: 262-633-8160
  • Fax: 262-633-3512
Mailing address:
  • Phone: 262-633-8160
  • Fax: 262-633-3512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. IRENE LOUISE PARENT
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: D.C.
Phone: 262-633-8160