Lifetime Wellness Chiropractic PLLC
Chiropractor in Shelley, ID. Organization (NPI-2).
NPI number1962734889
StatusActive
Last updated in NPPESNov 21, 2025
Details
- NPI
- 1962734889
- Entity type
- Organization (NPI-2)
- Legal business name
- Lifetime Wellness Chiropractic PLLC
- Organization subpart
- No
- Enumeration date
- Feb 3, 2010
- Certification date
- Nov 21, 2025
- Last updated
- Nov 21, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | CHIA-1397 | ID | Yes |
Practice location
528 N. State StShelley, ID 83274-1154
Phone 208-357-0333 · Fax 208-357-2299
Mailing address
528 N. State StShelley, ID 83274-1154
Phone 208-357-0333 · Fax 208-357-2299
Authorized official
Brennan T Williams
Member
2085525555
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 10 Chiropractor providers in Shelley · All 91 providers in Shelley
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