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General NPI Number Information
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NPI Number | 1770103525
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Entity Type | Organization
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Legal Business Name | HEALTHY LIFE CHIROPRACTIC
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Dates
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Enumeration Date | 04/22/2020
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Last Update Date | 04/28/2020
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Provider Practice Location Address
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Address Line | 4401 N I 35 UNIT 103
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City | DENTON
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State | TX
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Zip | 76207-3433
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Country | US
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Telephone | 940-222-6264
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Fax |
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Provider Business Mailing Address
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Address Line | 4124 CADENA RD
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City | DENTON
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State | TX
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Zip | 76210-4625
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Country | US
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Telephone | 940-222-6264
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Fax |
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Authorized Official
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Title or Position | OWNER/DC
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Name | DR. JASON MANIN
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Credential | DC
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Telephone | 940-222-6264
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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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