Provider Demographics
NPI:1588187249
Name:HEALTH FOR LIFE, PC
Entity Type:Organization
Organization Name:HEALTH FOR LIFE, PC
Other - Org Name:INBALANCE CHIROPRACTIC & WELLNESS- EAST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-425-3304
Mailing Address - Street 1:352 BOSTON TPKE
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-3873
Mailing Address - Country:US
Mailing Address - Phone:508-425-3304
Mailing Address - Fax:508-425-3306
Practice Address - Street 1:440 ARSENAL ST STE 4
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-2898
Practice Address - Country:US
Practice Address - Phone:617-926-0272
Practice Address - Fax:617-926-5430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-24
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA924OtherINDIVIDUAL CHIROPRACTIC LICENSE