Provider Demographics
NPI:1093029829
Name:MOLIVER CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:MOLIVER CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:LOREN
Authorized Official - Last Name:MOLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-930-9539
Mailing Address - Street 1:624 JETTON ST
Mailing Address - Street 2:SUITE 260
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-9315
Mailing Address - Country:US
Mailing Address - Phone:704-896-3435
Mailing Address - Fax:704-896-3424
Practice Address - Street 1:624 JETTON ST
Practice Address - Street 2:SUITE 260
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-9315
Practice Address - Country:US
Practice Address - Phone:704-896-3435
Practice Address - Fax:704-896-3424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3526111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty