OrganizationLife Clinic Of Ga PcChiropractorChiropractic ProvidersPractice Address14200 Highway 92, Woodstock, GA 30188-7139(952) 229-7464PECOS EnrollmentBased on the most recent information from CMS, provider Life Clinic Of Ga Pc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 34 days ago.Profile DetailsProvider ID1922752807Provider TypeOrganizationFull NameLife Clinic Of Ga PcSubpartNoEnumeration Date2/9/2022Last Updated2/9/2022Contact InformationPractice LocationPractice Address14200 Highway 92, Woodstock, GA 30188-7139Phone(952) 229-7464FaxUnlisted FaxMailing LocationMailing AddressPO Box 549, Chanhassen, MN 55317-0549PhoneUnlisted PhoneFaxUnlisted FaxAuthorized OfficialNameAlizadeh, Reza (President)Phone(612) 868-6894Provider TaxonomiesCodeDescriptionLicenseCode111N00000XPrimaryDescriptionChiropractorChiropractic ProvidersLicenseUnlisted IssuerCode225100000XDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted Issuer