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General NPI Number Information
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NPI Number | 1194001065
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Entity Type | Organization
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Legal Business Name | QUALITY OF LIFE: A CHIROPRACTIC WELLNESS CENTER
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Dates
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Enumeration Date | 10/24/2011
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Last Update Date | 10/24/2011
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Provider Practice Location Address
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Address Line | 1904 FRANKLIN ST #310
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City | OAKLAND
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State | CA
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Zip | 94612-2912
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Country | US
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Telephone | 510-213-8202
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 27492
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City | OAKLAND
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State | CA
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Zip | 94602-0992
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Country | US
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Telephone | 510-213-8202
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Fax |
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Authorized Official
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Title or Position | CO-OWNER, DOCTOR
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Name | DR. MARSHEA DARLENE EVANS
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Credential | D.C.
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Telephone | 510-213-8202
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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 | DC31404
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DCC31571
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License Number State | CA
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