Provider Demographics
NPI:1073636726
Name:TOTAL LIFE CHIROPRACTIC CLINIC
Entity type:Organization
Organization Name:TOTAL LIFE CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCARBOROUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-312-4470
Mailing Address - Street 1:2000 NE NEFF RD
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6212
Mailing Address - Country:US
Mailing Address - Phone:541-312-4470
Mailing Address - Fax:541-312-4430
Practice Address - Street 1:2000 NE NEFF RD
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-6212
Practice Address - Country:US
Practice Address - Phone:541-312-4470
Practice Address - Fax:541-312-4430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27 2730111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty