| Lifetime Wellness Chiropractic Pllc | |
|
528 N. State St, Shelley, ID 83274-1154 | |
| (208) 357-0333 | |
| (208) 357-2299 |
| Full Name | Lifetime Wellness Chiropractic Pllc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 528 N. State St, Shelley, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962734889 | NPI | - | NPPES |
| 1962734889 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | CHIA-1397 (Idaho) | Primary |
| Provider Name | Brennan T Williams |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1811228521 PECOS PAC ID: 2961547716 Enrollment ID: I20100303001107 |
| Provider Name | Jordan D Keck |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1871950998 PECOS PAC ID: 2668779166 Enrollment ID: I20160329000912 |
| Provider Name | Kade Sterling Keck |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1346838232 PECOS PAC ID: 2769896323 Enrollment ID: I20210122001845 |
| Mailing Address | Practice Location Address |
|---|---|
| Lifetime Wellness Chiropractic Pllc 528 N. State St, Shelley, ID 83274-1154 Ph: (208) 357-0333 | Lifetime Wellness Chiropractic Pllc 528 N. State St, Shelley, ID 83274-1154 Ph: (208) 357-0333 |
Dr. Douglas Jed Peterson, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 650 N State St, Suite #1, Shelley, ID 83274 Phone: 208-357-2225 Fax: 208-357-2224 | |
Randall Searle, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 120 N Emerson Ave, Shelley, ID 83274 Phone: 208-357-1949 | |
Dr. Aaron Walter Nippert, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 650 N State St Ste 1, Shelley, ID 83274 Phone: 208-757-7300 | |
Elevated Life Family Chiropractic Pllc Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 120 N Emerson Ave, Shelley, ID 83274 Phone: 208-357-1949 | |
Nippert Chiropractic Health Center, P.a. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 650 N State St Ste 1, Shelley, ID 83274 Phone: 214-288-5092 | |
Dr. Kade Keck, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 528 N State St, Shelley, ID 83274 Phone: 208-357-0333 | |
Dr. Brennan Todd Williams, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 528 N State St, Shelley, ID 83274 Phone: 208-357-0333 Fax: 208-357-2299 |