Provider Demographics
NPI:1225251580
Name:LIVINGSTON CHIROPRACTIC CLINIC, P.A.
Entity Type:Organization
Organization Name:LIVINGSTON CHIROPRACTIC CLINIC, P.A.
Other - Org Name:HOT SPRINGS CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICKY
Authorized Official - Middle Name:ROSEANN
Authorized Official - Last Name:LIVINGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:501-623-2701
Mailing Address - Street 1:242 HOBSON AVE
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-3746
Mailing Address - Country:US
Mailing Address - Phone:501-623-2701
Mailing Address - Fax:501-623-9105
Practice Address - Street 1:242 HOBSON AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-3746
Practice Address - Country:US
Practice Address - Phone:501-623-2701
Practice Address - Fax:501-623-9105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1441111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR145136718Medicaid
AR145137718Medicaid
AR145137718Medicaid
ARU67309Medicare UPIN