Provider Demographics
NPI:1588818173
Name:CHIROPRACTIC HEALTH & WELLNESS LLC
Entity Type:Organization
Organization Name:CHIROPRACTIC HEALTH & WELLNESS LLC
Other - Org Name:HEALTH 4 LIFE CHIROPRACTIC LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:F
Authorized Official - Last Name:RUFF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:308-633-3106
Mailing Address - Street 1:1124 BROADWAY STE B
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-3526
Mailing Address - Country:US
Mailing Address - Phone:308-633-3106
Mailing Address - Fax:308-633-4960
Practice Address - Street 1:1124 BROADWAY STE B
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-3526
Practice Address - Country:US
Practice Address - Phone:308-633-3106
Practice Address - Fax:308-633-4960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-09
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1517111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty