Provider Demographics
NPI:1043379753
Name:LIVINGSTON, RONEY (RPT)
Entity Type:Individual
Prefix:
First Name:RONEY
Middle Name:
Last Name:LIVINGSTON
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 694
Mailing Address - Street 2:
Mailing Address - City:HARTSELLE
Mailing Address - State:AL
Mailing Address - Zip Code:35640-0694
Mailing Address - Country:US
Mailing Address - Phone:256-773-3182
Mailing Address - Fax:256-773-8027
Practice Address - Street 1:9407 AL HWY 36 W
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:AL
Practice Address - Zip Code:35619
Practice Address - Country:US
Practice Address - Phone:256-773-3182
Practice Address - Fax:256-773-8027
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH222225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist