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General NPI Number Information
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NPI Number | 1164493763
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Entity Type | Organization
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Legal Business Name | A NEW LIFE CHIROPRACTIC & MASSAGE, PC
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Dates
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Enumeration Date | 01/31/2006
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Last Update Date | 11/23/2007
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Provider Practice Location Address
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Address Line | 3487 S LINDEN RD SUITE V
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City | FLINT
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State | MI
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Zip | 48507-3025
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Country | US
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Telephone | 810-230-5500
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Fax | 810-230-2895
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Provider Business Mailing Address
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Address Line | 3487 S LINDEN RD SUITE V
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City | FLINT
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State | MI
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Zip | 48507-3025
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Country | US
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Telephone | 810-230-5500
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Fax | 810-230-2895
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Authorized Official
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Title or Position | PRESIDENT
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Name | JASON PAUL CLIFT
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Credential | DC
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Telephone | 810-230-5500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2301007868
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License Number State | MI
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