Provider Demographics
NPI:1568892180
Name:LIFESTYLE HEALTHCARE, PLLC
Entity Type:Organization
Organization Name:LIFESTYLE HEALTHCARE, PLLC
Other - Org Name:LIFESTYLE CHIROPRACTIC AND MASSAGE, PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:DODSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-628-9966
Mailing Address - Street 1:134 KEENE RD
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-8683
Mailing Address - Country:US
Mailing Address - Phone:509-628-9966
Mailing Address - Fax:509-628-9976
Practice Address - Street 1:134 KEENE RD
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-8683
Practice Address - Country:US
Practice Address - Phone:509-628-9966
Practice Address - Fax:509-628-9976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-18
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty