Provider Demographics
NPI:1942220488
Name:NEW LIFE CHIROPRACTIC
Entity Type:Organization
Organization Name:NEW LIFE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYCE
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-964-2577
Mailing Address - Street 1:502 N ANKENY BLVD
Mailing Address - Street 2:STE 5
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-1755
Mailing Address - Country:US
Mailing Address - Phone:515-964-2577
Mailing Address - Fax:515-964-2588
Practice Address - Street 1:502 N ANKENY BLVD
Practice Address - Street 2:STE 5
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-1755
Practice Address - Country:US
Practice Address - Phone:515-964-2577
Practice Address - Fax:515-964-2588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06883111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0491472Medicaid
IA0491472Medicaid