Provider Demographics
NPI:1629205596
Name:BLCWC
Entity Type:Organization
Organization Name:BLCWC
Other - Org Name:BEST LIFE CHIROPRACTIC AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PLENTL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-649-2718
Mailing Address - Street 1:5072 W PLANO PKWY
Mailing Address - Street 2:SUITE 130
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4476
Mailing Address - Country:US
Mailing Address - Phone:214-649-2718
Mailing Address - Fax:
Practice Address - Street 1:5072 W PLANO PKWY
Practice Address - Street 2:SUITE 130
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4476
Practice Address - Country:US
Practice Address - Phone:214-649-2718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9521111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty