# LIFE CHIROPRACTIC AND INJURY CENTER LLC

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

## Provider details

- **NPI number:** 1508402074
- **Authorized official:** DR. BENJAMIN HANER DC (SOLE MEMBER)
- **Authorized official phone:** (240) 467-5600

## Contact information

- **Practice address:** 6103 BALTIMORE AVE STE 101, RIVERDALE, MD 20737-1966
- **Practice address phone:** (240) 467-5600
- **Practice address fax:** (240) 467-5626
- **Mailing address:** 6103 BALTIMORE AVE STE 101, RIVERDALE, MD 20737-1966
- **Mailing address phone:** (240) 467-5600
- **Mailing address fax:** (240) 467-5626

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/20/2019
- **Last updated:** 11/20/2019