Provider Demographics
NPI:1033784376
Name:LIVINGSTON, ERIC (BC-HIS)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:
Last Name:LIVINGSTON
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375- 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302
Mailing Address - Country:US
Mailing Address - Phone:319-377-1810
Mailing Address - Fax:319-377-4260
Practice Address - Street 1:1375- 7TH AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302
Practice Address - Country:US
Practice Address - Phone:319-377-1810
Practice Address - Fax:319-377-4260
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0610237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist