MEDICARE: LIFESTYLE CHIROPRACTIC, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	007502	IA

General Provider Information

NPI Number	:	1285979401
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFESTYLE CHIROPRACTIC, LLC

Provider Business Mailing Address
First Line	:	1264 CUMMINS RD
Second Line	:	APT 304
City	:	DES MOINES
State	:	IA
Zip	:	50315-2602
Country	:	US
Telephone Number	:	515-989-0097
Fax Number	:

Provider Business Practice Location Address
First Line	:	204 S 1ST ST
Second Line	:
City	:	CARLISLE
State	:	IA
Zip	:	50047-7601
Country	:	US
Telephone Number	:	515-989-0097
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. CHELSEA M SOGARD
Credential	:	D.C.
Telephone Number	:	515-989-0097

Provider Enumeration Date	:	11/28/2012
Last Update Date	:	01/18/2013

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Directions to “LIFESTYLE CHIROPRACTIC, LLC ” Practice Location

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