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General NPI Number Information
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NPI Number | 1235653726
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Entity Type | Organization
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Legal Business Name | HEALTHY LIFE CHIROPRACTIC & WELLNESS, LLC
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Dates
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Enumeration Date | 07/27/2017
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Last Update Date | 02/09/2021
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Provider Practice Location Address
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Address Line | 4078 W COUNTY ROAD 42
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City | SAVAGE
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State | MN
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Zip | 55378-2023
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Country | US
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Telephone | 952-838-5233
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Fax |
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Provider Business Mailing Address
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Address Line | 2209 RIVER HILLS DR
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City | BURNSVILLE
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State | MN
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Zip | 55337-1170
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Country | US
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Telephone | 952-838-5233
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. NEVILLE LAMBOURNE
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Credential | DC
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Telephone | 952-882-4654
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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 | 6261
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License Number State | MN
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