Provider Demographics
NPI:1467852772
Name:ADJUST YOUR LIFE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ADJUST YOUR LIFE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRENCE
Authorized Official - Middle Name:JUSTIN
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:413-998-3482
Mailing Address - Street 1:627 COLLEGE HWY
Mailing Address - Street 2:STE 2
Mailing Address - City:SOUTHWICK
Mailing Address - State:MA
Mailing Address - Zip Code:01077-9828
Mailing Address - Country:US
Mailing Address - Phone:413-998-3482
Mailing Address - Fax:413-998-3539
Practice Address - Street 1:627 COLLEGE HWY
Practice Address - Street 2:STE 2
Practice Address - City:SOUTHWICK
Practice Address - State:MA
Practice Address - Zip Code:01077-9828
Practice Address - Country:US
Practice Address - Phone:413-998-3482
Practice Address - Fax:413-998-3539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3225111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty