MEDICARE: LIFE CHIROPRACTIC SF

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	32492	CA

General Provider Information

NPI Number	:	1942664198
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE CHIROPRACTIC SF

Provider Business Mailing Address
First Line	:	644 LAGUNA ST.
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-4217
Country	:	US
Telephone Number	:	415-626-5433
Fax Number	:

Provider Business Practice Location Address
First Line	:	644 LAGUNA ST.
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-4217
Country	:	US
Telephone Number	:	415-626-5433
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR OF CHIROPRACTIC/BUSINESS OWN
Name	:	DR. AUSTIN DAVIS
Credential	:	D.C.
Telephone Number	:	415-626-5433

Provider Enumeration Date	:	04/13/2016
Last Update Date	:	04/13/2016

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