| Bold Life Chiropractic, Llc | |
|
427 E Main St, Prattville, AL 36067-3409 | |
| (334) 356-5571 | |
| (334) 730-0971 |
| Full Name | Bold Life Chiropractic, Llc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 427 E Main St, Prattville, Alabama |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518390293 | NPI | - | NPPES |
| 1145 | Other | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Joshua White |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1861759425 PECOS PAC ID: 2668612078 Enrollment ID: I20130709000041 |
| Provider Name | Amanda M White |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1851577480 PECOS PAC ID: 8123402336 Enrollment ID: I20220907000239 |
| Mailing Address | Practice Location Address |
|---|---|
| Bold Life Chiropractic, Llc 427 E Main St, Prattville, AL 36067-3409 Ph: (334) 356-5571 | Bold Life Chiropractic, Llc 427 E Main St, Prattville, AL 36067-3409 Ph: (334) 356-5571 |
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