# LIFETIME CHIROPRACTIC PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003049008
- **Authorized official:** DR. JODY A MATTHEWS DC,BA (OWNER)
- **Authorized official phone:** (770) 459-5070

## Contact information

- **Practice address:** 120 PROSPECTER DR, VILLA RICA, GA 30180-5331
- **Practice address phone:** (770) 459-5070
- **Practice address fax:** (770) 459-1070
- **Mailing address:** 120 PROSPECTER DR, VILLA RICA, GA 30180-5331
- **Mailing address phone:** (770) 459-5070
- **Mailing address fax:** (770) 459-1070

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NR0400X | Rehabilitation Chiropractor | — | NULL | Yes |
| 111NR0400X | Rehabilitation Chiropractor | — | — | Yes |

## Other

- **Enumeration date:** 08/25/2009
- **Last updated:** 08/25/2009