Provider Demographics
NPI:1073708855
Name:LIVING HEALTH CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:LIVING HEALTH CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WINTER
Authorized Official - Middle Name:M
Authorized Official - Last Name:GUFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:518-477-6330
Mailing Address - Street 1:91 TROY RD
Mailing Address - Street 2:
Mailing Address - City:EAST GREENBUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12061-1348
Mailing Address - Country:US
Mailing Address - Phone:518-477-6330
Mailing Address - Fax:518-477-5085
Practice Address - Street 1:91 TROY RD
Practice Address - Street 2:
Practice Address - City:EAST GREENBUSH
Practice Address - State:NY
Practice Address - Zip Code:12061-1348
Practice Address - Country:US
Practice Address - Phone:518-477-6330
Practice Address - Fax:518-477-5085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011349-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU99260OtherUPIN
NY10130289OtherCDPHP
NY1099624OtherASH
NY7981933OtherAETNA
NY6010647OtherMVP
NY714544OtherUNITED HEALTHCARE
NY6010647OtherMVP
NYBA1175Medicare PIN
NY6010647OtherMVP