Provider Demographics
NPI:1265982656
Name:FAMILY LIFE CHIROPRACTIC, INC
Entity type:Organization
Organization Name:FAMILY LIFE CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:EMILEE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:940-867-6563
Mailing Address - Street 1:3730 N JOSEY LN
Mailing Address - Street 2:#122
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-2484
Mailing Address - Country:US
Mailing Address - Phone:940-867-6563
Mailing Address - Fax:
Practice Address - Street 1:3730 N JOSEY LN
Practice Address - Street 2:#122
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-2484
Practice Address - Country:US
Practice Address - Phone:940-867-6563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-10
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13187111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty