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General NPI Number Information
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NPI Number | 1811263270
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Entity Type | Organization
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Legal Business Name | ABUNDANT LIFE FAMILY CHIROPRACTIC LLC
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 06/30/2015
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Provider Practice Location Address
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Address Line | 100 BEL AIR ST
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City | BOAZ
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State | AL
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Zip | 35957
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Country | US
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Telephone | 256-840-4000
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Fax | 256-840-4008
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Provider Business Mailing Address
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Address Line | 102 COLLEGE AVE
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City | BOAZ
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State | AL
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Zip | 35957-1606
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Country | US
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Telephone | 256-840-4000
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Fax | 256-840-4008
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. DARLA SUE LASSETER
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Credential | D.C.
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Telephone | 256-840-4000
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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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