Provider Demographics
NPI:1407291313
Name:LIVINGSTON, STACY J (DC)
Entity Type:Individual
Prefix:DR
First Name:STACY
Middle Name:J
Last Name:LIVINGSTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 WESTVIEW PARK PL
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-1401
Mailing Address - Country:US
Mailing Address - Phone:406-314-4632
Mailing Address - Fax:406-314-4633
Practice Address - Street 1:105 WESTVIEW PARK PL
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-1401
Practice Address - Country:US
Practice Address - Phone:406-314-4632
Practice Address - Fax:406-314-4633
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTCHI-CHI-LIC-2367111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor