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LIFE SOURCE CHIROPRACTIC INC. NPI 1669731477


NPI Information

NPI: 1669731477
Provider Name: LIFE SOURCE CHIROPRACTIC INC.
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
90 MAHONEY AVE
RUTLAND, VT
ZIP 05701
Phone: (802) 773-0010
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LIFE SOURCE CHIROPRACTIC INC. is a chiropractor in Rutland, VT. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. LIFE SOURCE CHIROPRACTIC INC. NPI is 1669731477. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

90 MAHONEY AVE
RUTLAND, VT
ZIP 05701-836
Phone: (802) 773-0010
Fax: (802) 773-0010

The provider's authorized official is Jared Galster .
The authorized official title is President and has the following contact phone number (802) 773-0010.

The enumeration date for this NPI number is 5/14/2012 and was last updated on 8/26/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1111N00000XChiropractor0060072505VERMONTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10028156OTHERVERMONTMEDICARE PTAN
21022039MEDICAIDVERMONT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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