Organization
ACTIVE LIFESTYLE CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER RENEE WINTON DC (OWNER)
(480) 704-1050
Entity
Organization
Contact information
Practice address
16515 S 40TH ST, SUITE 129, PHOENIX, AZ 85048-0558
(480) 704-1050
(480) 704-0109
Mailing address
16515 S 40TH ST, SUITE 129, PHOENIX, AZ 85048-0558
(480) 704-1050
(480) 704-0109
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7750
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z111783
PTAN
—
Enumeration date
04/20/2011
Last updated
04/20/2011
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