Provider Demographics
NPI:1497993315
Name:HEALTH FOR LIFE INC
Entity Type:Organization
Organization Name:HEALTH FOR LIFE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:L
Authorized Official - Last Name:STANBRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-475-6800
Mailing Address - Street 1:6033 S. FASHION POINTE DR
Mailing Address - Street 2:SUITE #120
Mailing Address - City:SOUTH OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403
Mailing Address - Country:US
Mailing Address - Phone:801-475-6800
Mailing Address - Fax:801-475-6802
Practice Address - Street 1:6033 S. FASHION POINTE DR
Practice Address - Street 2:SUITE #120
Practice Address - City:SOUTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403
Practice Address - Country:US
Practice Address - Phone:801-475-6800
Practice Address - Fax:801-475-6802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-30
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4804147-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty