Provider Demographics
NPI:1497258701
Name:LYFE CHIROPRACTIC & WELLNESS, PLLC
Entity Type:Organization
Organization Name:LYFE CHIROPRACTIC & WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:603-777-6712
Mailing Address - Street 1:428 LAFAYETTE ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842
Mailing Address - Country:US
Mailing Address - Phone:603-777-6712
Mailing Address - Fax:
Practice Address - Street 1:428 LAFAYETTE ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842
Practice Address - Country:US
Practice Address - Phone:603-777-6712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty