Provider Demographics
NPI:1821300815
Name:NEW LIFE CHIROPRACTIC, KINESIOLOGY AND ACUPUNCTURE
Entity Type:Organization
Organization Name:NEW LIFE CHIROPRACTIC, KINESIOLOGY AND ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:BESS
Authorized Official - Last Name:RAYFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-531-5729
Mailing Address - Street 1:879 W AGATE AVE
Mailing Address - Street 2:BOX 1223
Mailing Address - City:GRANBY
Mailing Address - State:CO
Mailing Address - Zip Code:80446-1223
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:879 W AGATE AVE
Practice Address - Street 2:
Practice Address - City:GRANBY
Practice Address - State:CO
Practice Address - Zip Code:80446
Practice Address - Country:US
Practice Address - Phone:970-531-5729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-08
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6404111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty