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General NPI Number Information
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NPI Number | 1184375750
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Entity Type | Organization
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Legal Business Name | GOOD LIFE CHIROPRACTIC LLC
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Dates
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Enumeration Date | 01/14/2022
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Last Update Date | 01/20/2022
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Provider Practice Location Address
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Address Line | 975 NE RICE RD
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City | LEES SUMMIT
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State | MO
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Zip | 64086-6359
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Country | US
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Telephone | 402-570-0043
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Fax |
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Provider Business Mailing Address
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Address Line | 229 NW KESSLER DR APT 108
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City | LEES SUMMIT
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State | MO
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Zip | 64081-4171
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Country | US
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Telephone | 402-570-0043
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KARLYE CAROL EDDINS
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Credential | DC
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Telephone | 402-570-0043
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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 |
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License Number State |
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