Provider Demographics
NPI:1992946057
Name:NEW LIFE HEALTH CENTER
Entity type:Organization
Organization Name:NEW LIFE HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:LOTTERER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:678-721-0096
Mailing Address - Street 1:4 S TENNESSEE ST STE B
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-3357
Mailing Address - Country:US
Mailing Address - Phone:678-721-0096
Mailing Address - Fax:678-721-0824
Practice Address - Street 1:4 S TENNESSEE ST STE B
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-3357
Practice Address - Country:US
Practice Address - Phone:678-721-0096
Practice Address - Fax:678-721-0824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIROO7426111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty