Provider Demographics
NPI:1508989336
Name:LIVINGSTON, ROBERT WALTERS III (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WALTERS
Last Name:LIVINGSTON
Suffix:III
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:PO BOX 96
Mailing Address - Street 2:
Mailing Address - City:TREXLERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18087-0096
Mailing Address - Country:US
Mailing Address - Phone:610-972-2462
Mailing Address - Fax:
Practice Address - Street 1:8026 HAMILTON BLVD
Practice Address - Street 2:
Practice Address - City:BREINIGSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18031-1219
Practice Address - Country:US
Practice Address - Phone:610-395-5509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-08
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009783111N00000X
PAAK000923171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist