Provider Demographics
NPI:1659668960
Name:A NEW LIFE WELLNESS CENTER, INC
Entity Type:Organization
Organization Name:A NEW LIFE WELLNESS CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:POTTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-751-8200
Mailing Address - Street 1:16831 E ILIFF AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-1579
Mailing Address - Country:US
Mailing Address - Phone:303-751-8200
Mailing Address - Fax:303-751-7777
Practice Address - Street 1:16831 E ILIFF AVE
Practice Address - Street 2:SUITE B
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-1579
Practice Address - Country:US
Practice Address - Phone:303-751-8200
Practice Address - Fax:303-751-7777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4601111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty