Provider Demographics
NPI:1184842114
Name:LIFE AND HEALTH CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:LIFE AND HEALTH CHIROPRACTIC, INC.
Other - Org Name:LIFE AND HEALTH CHIROPRACTIC CENTRE, P.S.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:MOSS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-944-7620
Mailing Address - Street 1:34503 9TH AVE S STE 320
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-8726
Mailing Address - Country:US
Mailing Address - Phone:253-944-7620
Mailing Address - Fax:253-944-7621
Practice Address - Street 1:34503 9TH AVE S STE 320
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8726
Practice Address - Country:US
Practice Address - Phone:253-944-7620
Practice Address - Fax:253-944-7621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003349111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty