Provider Demographics
NPI:1831664903
Name:LIFEWORKS CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:LIFEWORKS CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:PENZARELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:617-744-3016
Mailing Address - Street 1:96 HOLLAND ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-2707
Mailing Address - Country:US
Mailing Address - Phone:215-859-0761
Mailing Address - Fax:
Practice Address - Street 1:96 HOLLAND ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-2707
Practice Address - Country:US
Practice Address - Phone:215-859-0761
Practice Address - Fax:949-955-7480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-04
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty