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General NPI Number Information
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NPI Number | 1205975679
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Entity Type | Organization
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Legal Business Name | LIFELINE CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5920 HIGHWAY 5 N SUITE 7
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City | BRYANT
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State | AR
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Zip | 72022-8555
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Country | US
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Telephone | 501-847-7026
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Fax | 501-847-7016
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Provider Business Mailing Address
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Address Line | 5920 HIGHWAY 5 N SUITE 7
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City | BRYANT
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State | AR
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Zip | 72022-8555
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Country | US
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Telephone | 501-847-7026
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Fax | 501-847-7016
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Authorized Official
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Title or Position | OWNER
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Name | DR. MELANIE GRIFFIN
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Credential | D.C.
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Telephone | 501-847-7026
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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 | 1683
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License Number State | AR
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