Provider Demographics
NPI:1790118982
Name:TRUE LIFE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:TRUE LIFE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MICHAUD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:907-433-9973
Mailing Address - Street 1:550 E TUDOR RD STE 203
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-7371
Mailing Address - Country:US
Mailing Address - Phone:907-433-9973
Mailing Address - Fax:907-677-1880
Practice Address - Street 1:550 E TUDOR RD STE 203
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-7371
Practice Address - Country:US
Practice Address - Phone:907-433-9973
Practice Address - Fax:907-677-1880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-12
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK512111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty