| Life University, Inc | |
|
1415 Barclay Cir Se, Marietta, GA 30060-2943 | |
| (770) 792-6100 | |
| Not Available |
| Full Name | Life University, Inc |
|---|---|
| Type | Facility |
| Speciality | Clinic/center |
| Location | 1415 Barclay Cir Se, Marietta, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902033343 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Stephanie Antoline |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1578787651 PECOS PAC ID: 6608832266 Enrollment ID: I20041206000308 |
| Provider Name | Kent D Vanderslice |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1710008412 PECOS PAC ID: 6002833407 Enrollment ID: I20051025000738 |
| Provider Name | Michael L Tomasello |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1700807930 PECOS PAC ID: 5193729630 Enrollment ID: I20060914000183 |
| Provider Name | Richard J Decarlo |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1538216924 PECOS PAC ID: 1355493180 Enrollment ID: I20090709000033 |
| Provider Name | Kelly Ann Morgenroth |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1699933788 PECOS PAC ID: 0547443434 Enrollment ID: I20110331000009 |
| Provider Name | Paul R Blumsack |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1568769990 PECOS PAC ID: 9830367051 Enrollment ID: I20110714000059 |
| Provider Name | Kadria Raynelle Griffiths |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1114302288 PECOS PAC ID: 6608186978 Enrollment ID: I20151117002994 |
| Provider Name | Robert Love |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1780045021 PECOS PAC ID: 3779880042 Enrollment ID: I20160331002422 |
| Provider Name | Kaitlyn Beth Vanstrien |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1750736526 PECOS PAC ID: 8426340449 Enrollment ID: I20160712003119 |
| Provider Name | Alysa J Smith |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1487155644 PECOS PAC ID: 7618222761 Enrollment ID: I20180614000711 |
| Provider Name | William E Hamilton |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1326104886 PECOS PAC ID: 2567705841 Enrollment ID: I20190530001795 |
| Provider Name | Michael Paul Abbatinozzi |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1801003264 PECOS PAC ID: 7517375843 Enrollment ID: I20210426001458 |
| Provider Name | Timothy P Conroy |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1912047366 PECOS PAC ID: 0547330078 Enrollment ID: I20210504001385 |
| Provider Name | Daniel Jared Smith |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1124379094 PECOS PAC ID: 3173932530 Enrollment ID: I20210514001653 |
| Provider Name | Irving Russell |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1912175530 PECOS PAC ID: 1658770680 Enrollment ID: I20210525001557 |
| Provider Name | Margaret Clough |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1255809646 PECOS PAC ID: 7618356643 Enrollment ID: I20220622002614 |
| Provider Name | Brian Healy |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1215992136 PECOS PAC ID: 2466598610 Enrollment ID: I20230821000407 |
| Provider Name | Crystal Hickman |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1417637836 PECOS PAC ID: 0345694592 Enrollment ID: I20230921004317 |
| Provider Name | Tara Vanvranken |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1326599614 PECOS PAC ID: 6406205822 Enrollment ID: I20231211003155 |
| Provider Name | Seth Chad Strauss |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1518387299 PECOS PAC ID: 3971812207 Enrollment ID: I20240506004185 |
| Provider Name | Michael Cartwright |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1467541276 PECOS PAC ID: 5496755407 Enrollment ID: I20240703002015 |
| Provider Name | Jesslian Rosa Rosado |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1922841170 PECOS PAC ID: 6305381054 Enrollment ID: I20240717002905 |
| Provider Name | Daniel Gambino |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1265599765 PECOS PAC ID: 7214011287 Enrollment ID: I20250117002030 |
| Provider Name | Philip Wagner |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1043296171 PECOS PAC ID: 2769911577 Enrollment ID: I20250123002127 |
| Provider Name | Alyssa Kurtiak |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1023659117 PECOS PAC ID: 0648607762 Enrollment ID: I20250211000853 |
| Provider Name | William Abner Hatten |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1538696885 PECOS PAC ID: 0244750362 Enrollment ID: I20250219003791 |
| Mailing Address | Practice Location Address |
|---|---|
| Life University, Inc 1415 Barclay Cir Se, Marietta, GA 30060-2943 Ph: (770) 426-2809 | Life University, Inc 1415 Barclay Cir Se, Marietta, GA 30060-2943 Ph: (770) 792-6100 |