Lifetime Wellness of Boulder LLC

Primary specialty

Pediatric ChiropractorTaxonomy code 111NP0017X

License

6715 Issued in CO

Legal business name

LIFETIME WELLNESS OF BOULDER LLC

Practice address

2800 Folsom St
Suite D
Boulder, CO 80304-3738

Phone

(303) 374-4856

NPI assigned

Apr 27, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Amanda Friedhoff, D.C.

Title

Ceo

Phone

(303) 374-4856

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430092800000",
    "number": "1952788093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4206",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803064206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 FOLSOM ST",
            "address_2": "SUITE D",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043738",
            "telephone_number": "303-374-4856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME WELLNESS OF BOULDER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-27",
        "last_updated": "2015-04-27",
        "status": "A",
        "authorized_official_last_name": "FRIEDHOFF",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "303-374-4856",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NP0017X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "CO",
            "license": "6715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lifetime Wellness, Inc.
• William C Lillydahl, M.D.
• Li Lin
• Andrew Linares, MA
• Linda Ciampoli, LLC

• Pediatric Chiropractor in Boulder, CO
• Providers in Boulder, CO by specialty
• Pediatric Chiropractor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.