Provider Demographics
NPI:1659413979
Name:NATURAL LIFE CENTERS, LTD.
Entity Type:Organization
Organization Name:NATURAL LIFE CENTERS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OF STAFF
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:WOOLF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-864-0036
Mailing Address - Street 1:2830 W NORTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-6626
Mailing Address - Country:US
Mailing Address - Phone:602-864-0036
Mailing Address - Fax:602-864-0065
Practice Address - Street 1:10723 W INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-5636
Practice Address - Country:US
Practice Address - Phone:623-848-6991
Practice Address - Fax:623-848-6993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4228111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0232770OtherBCBS OF ARIZONA
AZ35WCHHM13Medicare ID - Type Unspecified
AZAZ0232770OtherBCBS OF ARIZONA