Provider Demographics
NPI:1710122072
Name:TRUE LIFE CHIROPRACTIC
Entity Type:Organization
Organization Name:TRUE LIFE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:BOENDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-634-8137
Mailing Address - Street 1:12256 STATE LINE RD
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66209-1256
Mailing Address - Country:US
Mailing Address - Phone:913-345-9888
Mailing Address - Fax:
Practice Address - Street 1:12256 STATE LINE RD
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66209-1256
Practice Address - Country:US
Practice Address - Phone:913-345-9888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05219111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty