Provider Demographics
NPI:1356764609
Name:LIFE CHANGING CHIROPRACTIC
Entity type:Organization
Organization Name:LIFE CHANGING CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEEK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-395-5554
Mailing Address - Street 1:11477 CUSTER RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-8785
Mailing Address - Country:US
Mailing Address - Phone:512-395-5554
Mailing Address - Fax:
Practice Address - Street 1:11477 CUSTER RD
Practice Address - Street 2:SUITE 106
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-8785
Practice Address - Country:US
Practice Address - Phone:512-395-5554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AWS DC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-22
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11574111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty