Provider Demographics
NPI:1336489756
Name:ABS 4 LIFE, LLC
Entity Type:Organization
Organization Name:ABS 4 LIFE, LLC
Other - Org Name:ROGERSVILLE FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-810-3916
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35652-0219
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17520 HWY 72
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35652-8134
Practice Address - Country:US
Practice Address - Phone:256-229-6992
Practice Address - Fax:256-229-6688
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABS 4 LIFE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-21
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1768111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty