Provider Demographics
NPI:1689486151
Name:ESSENTIAL LIFE CHIROPRACTIC & WELLNESS
Entity type:Organization
Organization Name:ESSENTIAL LIFE CHIROPRACTIC & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRACTICIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAWANA
Authorized Official - Middle Name:JANAY
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-399-3735
Mailing Address - Street 1:13350 WATER OAK LN STE B
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-3763
Mailing Address - Country:US
Mailing Address - Phone:512-399-3735
Mailing Address - Fax:
Practice Address - Street 1:4412 SPICEWOOD SPRINGS RD STE 501
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8695
Practice Address - Country:US
Practice Address - Phone:512-399-3735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty