Provider Demographics
NPI:1265034284
Name:100 PERCENT CHIROPRACTIC LIVINGOOD CO INC APC
Entity Type:Organization
Organization Name:100 PERCENT CHIROPRACTIC LIVINGOOD CO INC APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRANCHISEE
Authorized Official - Prefix:
Authorized Official - First Name:ELLENA
Authorized Official - Middle Name:
Authorized Official - Last Name:WENGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-217-0895
Mailing Address - Street 1:15400 W 64TH AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80007-6852
Mailing Address - Country:US
Mailing Address - Phone:970-623-4301
Mailing Address - Fax:
Practice Address - Street 1:15400 W 64TH AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80007-6852
Practice Address - Country:US
Practice Address - Phone:720-524-8174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty