Provider Demographics
NPI:1114513884
Name:ENHANCED LIFE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ENHANCED LIFE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:FRANCO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:504-452-9561
Mailing Address - Street 1:20324 KINGLAND DR
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-0572
Mailing Address - Country:US
Mailing Address - Phone:504-452-9561
Mailing Address - Fax:
Practice Address - Street 1:20324 KINGLAND DR
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-0572
Practice Address - Country:US
Practice Address - Phone:504-452-9561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service