Provider Demographics
NPI:1881726545
Name:HEALTH FOR LIFE CHIROPRACTIC AND
Entity type:Organization
Organization Name:HEALTH FOR LIFE CHIROPRACTIC AND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KORI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SPRINTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC, FIAMA
Authorized Official - Phone:480-610-5433
Mailing Address - Street 1:2665 E BROADWAY RD STE B112
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-1572
Mailing Address - Country:US
Mailing Address - Phone:480-610-5433
Mailing Address - Fax:480-610-5434
Practice Address - Street 1:2665 E BROADWAY RD STE B112
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-1572
Practice Address - Country:US
Practice Address - Phone:480-610-5433
Practice Address - Fax:480-610-5434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7452111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ83258Medicare PIN