LIFESTYLE BALANCE HEALTHCARE TRUST NPI 1972701688

NPI Information

LIFESTYLE BALANCE HEALTHCARE TRUST is a chiropractor in Mesa, AZ. 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. LIFESTYLE BALANCE HEALTHCARE TRUST NPI is 1972701688. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Lifestyle Balance Healthcare.

The provider's business location address is:

65 E 1ST AVE STE 101
MESA, AZ
ZIP 85210-456
Phone: (480) 962-4649
Fax: (480) 962-8617

The provider's authorized official is Larry Ross Johnston .
The authorized official title is Acting Chief Executive Officer and has the following contact phone number (480) 962-4649.

The enumeration date for this NPI number is 7/3/2007 and was last updated on 8/22/2020.

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:

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