Provider Demographics
NPI:1316006646
Name:BETTER LIFE CHIROPRACTIC AND MASSAGE P C
Entity Type:Organization
Organization Name:BETTER LIFE CHIROPRACTIC AND MASSAGE P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TORY
Authorized Official - Middle Name:D
Authorized Official - Last Name:NAUGLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-673-0190
Mailing Address - Street 1:2460 NW TROOST ST.
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-1611
Mailing Address - Country:US
Mailing Address - Phone:541-673-0190
Mailing Address - Fax:541-957-9410
Practice Address - Street 1:2460 NW TROOST ST.
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-1611
Practice Address - Country:US
Practice Address - Phone:541-673-0190
Practice Address - Fax:541-957-9410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3553111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR135912Medicare PIN