Provider Demographics
NPI:1023675014
Name:LIFESTYLE FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:LIFESTYLE FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARDIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHELLAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-824-1293
Mailing Address - Street 1:8751 COLLIN MCKINNEY PKWY STE 303
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-1658
Mailing Address - Country:US
Mailing Address - Phone:469-625-1100
Mailing Address - Fax:469-625-1143
Practice Address - Street 1:8751 COLLIN MCKINNEY PKWY STE 303
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-1658
Practice Address - Country:US
Practice Address - Phone:469-625-1100
Practice Address - Fax:469-625-1143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-24
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty