Provider Demographics
NPI:1851990972
Name:ABUNDANT LIFE CHIROPRACTIC
Entity Type:Organization
Organization Name:ABUNDANT LIFE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:850-566-7163
Mailing Address - Street 1:315 S SALEM ST STE 220
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-1848
Mailing Address - Country:US
Mailing Address - Phone:919-590-0637
Mailing Address - Fax:919-590-0638
Practice Address - Street 1:315 S SALEM ST STE 220
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-1848
Practice Address - Country:US
Practice Address - Phone:919-590-0637
Practice Address - Fax:919-590-0638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty