Provider Demographics
NPI:1417243080
Name:LIVE WELL CHIROPRACTIC CARE LLC
Entity Type:Organization
Organization Name:LIVE WELL CHIROPRACTIC CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ROSCO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-994-4541
Mailing Address - Street 1:33 CHURCH HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-1612
Mailing Address - Country:US
Mailing Address - Phone:203-270-6300
Mailing Address - Fax:203-724-0383
Practice Address - Street 1:33 CHURCH HILL RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-1612
Practice Address - Country:US
Practice Address - Phone:203-270-6300
Practice Address - Fax:203-724-0383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-22
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001884111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty