Provider Demographics
NPI:1033458484
Name:NEW LIFE CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:NEW LIFE CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAJINESS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:734-856-3400
Mailing Address - Street 1:7490 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48144-9607
Mailing Address - Country:US
Mailing Address - Phone:734-856-3400
Mailing Address - Fax:
Practice Address - Street 1:7490 SECOR RD
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:MI
Practice Address - Zip Code:48144-9607
Practice Address - Country:US
Practice Address - Phone:734-856-3400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-05
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRL008519111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty