Provider Demographics
NPI:1689705832
Name:LIFE EMPOWERMENT INSTITUTE
Entity Type:Organization
Organization Name:LIFE EMPOWERMENT INSTITUTE
Other - Org Name:LIFE EMPOWERMENT WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:TUMMINELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-255-4410
Mailing Address - Street 1:275 CARPENTER DR NE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4928
Mailing Address - Country:US
Mailing Address - Phone:404-255-4410
Mailing Address - Fax:
Practice Address - Street 1:275 CARPENTER DR NE
Practice Address - Street 2:SUITE 209
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4928
Practice Address - Country:US
Practice Address - Phone:404-255-4410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP4903Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER