Provider Demographics
NPI:1326305111
Name:LIFESTYLE CHIROPRACTIC P. C.
Entity type:Organization
Organization Name:LIFESTYLE CHIROPRACTIC P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:C
Authorized Official - Last Name:LAURIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-725-9501
Mailing Address - Street 1:5372 FALLOWATER LN STE B
Mailing Address - Street 2:
Mailing Address - City:CAVE SPRING
Mailing Address - State:VA
Mailing Address - Zip Code:24018-0909
Mailing Address - Country:US
Mailing Address - Phone:540-725-9501
Mailing Address - Fax:
Practice Address - Street 1:5372 FALLOWATER LN STE B
Practice Address - Street 2:
Practice Address - City:CAVE SPRING
Practice Address - State:VA
Practice Address - Zip Code:24018-0909
Practice Address - Country:US
Practice Address - Phone:540-725-9501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-18
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA350000773Medicare PIN