National Provider Identifier Database

LIFE SOURCE CHIROPRACTIC INC
Chiropractor

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.


Contact Information

LIFE SOURCE CHIROPRACTIC INC.
90 MAHONEY AVE
RUTLAND, VT05701-4836
Phone: 802-773-0010
Fax: 802-773-0010
Website:
Specialty Taxonomy Code
* Chiropractor 111N00000X

* Indicates primary specialty

NPI Profile & details for LIFE SOURCE CHIROPRACTIC INC.

NPI Number 1669731477
Legal business name
LBN
LIFE SOURCE CHIROPRACTIC INC.
Authorized official JARED GALSTER - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 05/14/2012
Last updated 08/26/2014 - About 12 years ago
Sole proprietor1 Not specified
Identifiers
  • VT License #: 0060072505
  • VT Medicaid: 1022039
  • VT Other: 0028156 MEDICARE PTAN

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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