Provider Demographics
NPI:1003053430
Name:BETTER LIFE CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:BETTER LIFE CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-940-9685
Mailing Address - Street 1:15 DOUGLAS WAY
Mailing Address - Street 2:
Mailing Address - City:ELDRIDGE
Mailing Address - State:IA
Mailing Address - Zip Code:52748-9572
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2711 W 63RD ST
Practice Address - Street 2:SUITE 4
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52806-1647
Practice Address - Country:US
Practice Address - Phone:563-359-1455
Practice Address - Fax:563-359-1498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007129111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty