Provider Demographics
NPI:1811939168
Name:LIFEWAY CHIROPRACTIC
Entity type:Organization
Organization Name:LIFEWAY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GILLIAN
Authorized Official - Middle Name:BROOKE
Authorized Official - Last Name:GUIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:615-465-8327
Mailing Address - Street 1:1224B COLUMBIA AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-3619
Mailing Address - Country:US
Mailing Address - Phone:615-465-8327
Mailing Address - Fax:
Practice Address - Street 1:1224B COLUMBIA AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-3619
Practice Address - Country:US
Practice Address - Phone:615-465-8327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2113111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty