Provider Demographics
NPI:1407272743
Name:NLWC, LLC
Entity Type:Organization
Organization Name:NLWC, LLC
Other - Org Name:NEW LIFE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE MEMBER AND MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:HEINES
Authorized Official - Last Name:SCHAGEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:413-443-3577
Mailing Address - Street 1:100 WENDELL AVE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-7065
Mailing Address - Country:US
Mailing Address - Phone:413-443-3577
Mailing Address - Fax:413-499-7852
Practice Address - Street 1:100 WENDELL AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-7065
Practice Address - Country:US
Practice Address - Phone:413-443-3577
Practice Address - Fax:413-499-7852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA611261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center