Provider Demographics
NPI:1184375750
Name:GOOD LIFE CHIROPRACTIC LLC
Entity type:Organization
Organization Name:GOOD LIFE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARLYE
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:EDDINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-570-0043
Mailing Address - Street 1:229 NW KESSLER DR APT 108
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-4171
Mailing Address - Country:US
Mailing Address - Phone:402-570-0043
Mailing Address - Fax:
Practice Address - Street 1:975 NE RICE RD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-6359
Practice Address - Country:US
Practice Address - Phone:402-570-0043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-14
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty