Provider Demographics
NPI:1518546910
Name:CONNECTED LIFE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:CONNECTED LIFE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAYLA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:NEUVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:507-993-9398
Mailing Address - Street 1:2510 14TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-7732
Mailing Address - Country:US
Mailing Address - Phone:507-993-9398
Mailing Address - Fax:
Practice Address - Street 1:275 37TH ST NE STE 200
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55906-5438
Practice Address - Country:US
Practice Address - Phone:507-218-7822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty