MAGNOLIA LIFE LLC (NPI# 1215445564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215445564 |
| Entity Type | Organization |
| Organization Name | MAGNOLIA LIFE LLC |
| Other Organization Name | MAGNOLIA TRIBE CHIROPRACTIC |
| Practice Address |
17287 Us Highway 331 S Freeport FL 32439-4206 |
| Practice Telephone | 8503129573 |
| Mailing Telephone | 8503129573 |
| Enumeration Date | 2018-01-19 |
| Last Update Date | 2018-01-19 |
| Authorized Official Name | DR. MORGAN LIGHTSEY-SANTOS (OWNER) |
| Authorized Official Telephone | 8503129573 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CH12326 | FL | Chiropractic Providers |
| Other Name | Type Code |
|---|---|
| Magnolia Tribe Chiropractic | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | MAGNOLIA LIFE LLC | 885 Field Club Rd, Pittsburgh, PA 15238-2428 |
| Alabama Business Registrations | Magnolia Life LLC | 325 Mithcell Creek Rdg, Wetumpka, AL 36093-3275 |
| Street Address |
17287 US HIGHWAY 331 S |
| City | FREEPORT |
| State | FL |
| Zip Code | 32439-4206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407364755 | Morgan Lightsey-santos | Chiropractor | 17287 Us Highway 331 S, Freeport, FL 32439-4206 | 2018-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518464767 | Molly Lutz | Specialist/Technologist | 12615 Business Hwy 331, Freeport, FL 32439 | 2018-04-12 |
| 1952840266 | Katherine Mclelland | Specialist/Technologist | 12615 U.S. 331 Bus, Freeport, FL 32439 | 2017-02-20 |
| 1497160360 | Jennewein, Np-c, LLC | Health Maintenance Organization | 40 Washington Street, Freeport, FL 32439 | 2014-06-30 |
| 1407292220 | Lauren Neighbors Youtz | Physician Assistant | 479 E. Hwy 20, Freeport, FL 32439 | 2013-05-20 |
| 1841537180 | Jeanne Elizabeth Brehm | Contractor | 2516 Co Hwy 3280, Freeport, FL 32439 | 2013-01-07 |
| 1417247529 | Lindsay L Shirley | Dentist | 30 Blueberry Road, Freeport, FL 32439 | 2011-04-10 |
| 1659476281 | Garlon Ray Weeks | Pharmacist | 132 East Hwy 20, Freeport, FL 32439 | 2006-09-14 |
| 1477595858 | Freeport Family Medicine LLC | Family Medicine | 1588 Highway 20 West, Freeport, FL 32439 | 2006-06-12 |
| 1366413049 | Christopher Ray Weeks | Pharmacist | 132 E Hwy 20, Freeport, FL 32439 | 2006-01-30 |
| 1992902100 | Freeport Family Chiropractic Clinic LLC | Chiropractor | 40 Washington St., Freeport, FL 32439 | 2007-06-29 |
| Find all providers in zip 32439 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891354460 | Freeport Chiropractic LLC | Chiropractor | 2 W Stephenson St, Freeport, IL 61032 | 2019-06-07 |
| 1407364755 | Morgan Lightsey-santos | Chiropractor | 17287 Us Highway 331 S, Freeport, FL 32439-4206 | 2018-01-19 |
| 1689804361 | Robert M Fair | Chiropractor | 506 High St, Freeport, PA 16229-1222 | 2009-07-16 |
| 1023244290 | Allies In Health Sc | Chiropractor | 418 W Meadows Dr., Freeport, IL 61032 | 2009-06-02 |
| 1952546707 | Schram Chiropractic Clinic PC | Chiropractor | 1009 Loras Drive, Freeport, IL 61032-6923 | 2008-12-09 |
| 1063692630 | Momentum Chiropractic, PC | Chiropractor | 24 W Merrick Rd, Freeport, NY 11520-3827 | 2007-11-12 |
| 1922139286 | Gregg F Brady | Chiropractor | 144 Kissick Ln, Freeport, PA 16229-1909 | 2007-03-08 |
| 1467592212 | Merritt Lowe Armstrong | Chiropractor | 30 Bow St, Freeport, ME 04032-1517 | 2007-02-08 |
| 1932260387 | Steven R Grunewald | Chiropractor | 1630 S Galena Ave, Ste A, Freeport, IL 61032-2518 | 2006-12-12 |
| 1205994605 | Jeremy Edwin Ronge | Chiropractor | 996 Freeport Rd, Freeport, PA 16229 | 2006-12-05 |
| Find all providers in FREEPORT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.