Provider Demographics
NPI:1194001065
Name:QUALITY OF LIFE: A CHIROPRACTIC WELLNESS CENTER
Entity Type:Organization
Organization Name:QUALITY OF LIFE: A CHIROPRACTIC WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER, DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARSHEA
Authorized Official - Middle Name:DARLENE
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:510-213-8202
Mailing Address - Street 1:PO BOX 27492
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-0992
Mailing Address - Country:US
Mailing Address - Phone:510-213-8202
Mailing Address - Fax:
Practice Address - Street 1:1904 FRANKLIN ST
Practice Address - Street 2:#310
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-2912
Practice Address - Country:US
Practice Address - Phone:510-213-8202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADCC31571111N00000X
CADC31404111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty