Provider Demographics
NPI:1134302490
Name:LIVE WELL CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:LIVE WELL CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FRANCAVILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-235-0995
Mailing Address - Street 1:1035 JUNIPER ST NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-4012
Mailing Address - Country:US
Mailing Address - Phone:404-235-0995
Mailing Address - Fax:
Practice Address - Street 1:1035 JUNIPER ST NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-4012
Practice Address - Country:US
Practice Address - Phone:404-235-0995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006309111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1437244639OtherNPI
GA1437244639OtherNPI