Provider Demographics
NPI:1982482535
Name:CHIRO LIFE HEALTH AND WELLNESS, PLLC
Entity type:Organization
Organization Name:CHIRO LIFE HEALTH AND WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:DAVETTE
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-303-7692
Mailing Address - Street 1:2701 W 15TH ST STE 514
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7523
Mailing Address - Country:US
Mailing Address - Phone:469-596-7699
Mailing Address - Fax:469-929-9250
Practice Address - Street 1:1809 K AVE STE 1
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-5907
Practice Address - Country:US
Practice Address - Phone:469-596-7699
Practice Address - Fax:469-929-9250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty