Provider Demographics
NPI:1992472039
Name:TREE OF LIFE FAMILY CHIROPRACTIC AND WELLNESS CENTER, LLC
Entity type:Organization
Organization Name:TREE OF LIFE FAMILY CHIROPRACTIC AND WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:NORTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:912-585-7429
Mailing Address - Street 1:2355 FLORIDA BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH DAYTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32119-3317
Mailing Address - Country:US
Mailing Address - Phone:912-585-7429
Mailing Address - Fax:
Practice Address - Street 1:1033 S RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-6151
Practice Address - Country:US
Practice Address - Phone:912-685-7429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty