Provider Demographics
NPI:1558613877
Name:LIFESTYLE CHIROPRACTIC AND WELLNESS LLC
Entity Type:Organization
Organization Name:LIFESTYLE CHIROPRACTIC AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-216-8778
Mailing Address - Street 1:1735 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-1315
Mailing Address - Country:US
Mailing Address - Phone:816-216-8778
Mailing Address - Fax:816-817-3280
Practice Address - Street 1:1735 WALNUT ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-1315
Practice Address - Country:US
Practice Address - Phone:816-216-8778
Practice Address - Fax:816-817-3280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-10
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012012018111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty