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NPI Code Detail

MEDICARE: HEALTHY LIFE CHIROPRACTIC AND WELLNESS, LLC

MEDICARE: HEALTHY LIFE CHIROPRACTIC AND WELLNESS, 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
1111N00000XChiropractor2002024752MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MA3515OTHERPTAN

General Provider Information

NPI Number : 1457621526
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTHY LIFE CHIROPRACTIC AND WELLNESS, LLC
Provider Business Mailing Address
First Line : 1601 BRYAN RD
Second Line :
City : O FALLON
State : MO
Zip : 63368-4815
Country : US
Telephone Number : 636-474-2273
Fax Number : 636-474-2272
Provider Business Practice Location Address
First Line : 1601 BRYAN RD
Second Line :
City : O FALLON
State : MO
Zip : 63368-4815
Country : US
Telephone Number : 636-474-2273
Fax Number : 636-474-2272
Authorized Official
Title or Position : OWNER/CHIROPRACTOR
Name : DR. JAMES WILLIAM HANKINSON
Credential : D.C
Telephone Number : 636-474-2273
Provider Enumeration Date : 01/06/2012
Last Update Date : 01/06/2012

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Directions to “HEALTHY LIFE CHIROPRACTIC AND WELLNESS, LLC ” Practice Location

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