Provider Demographics
NPI:1629318571
Name:LIVE WELL CHASE HEALTH LLC
Entity Type:Organization
Organization Name:LIVE WELL CHASE HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAISIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-463-4590
Mailing Address - Street 1:404 W HAND AVE
Mailing Address - Street 2:UNIT 200
Mailing Address - City:WILDWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08260-1548
Mailing Address - Country:US
Mailing Address - Phone:609-602-8515
Mailing Address - Fax:609-463-4591
Practice Address - Street 1:211 S MAIN ST
Practice Address - Street 2:UNIT 302
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2264
Practice Address - Country:US
Practice Address - Phone:609-463-4590
Practice Address - Fax:609-463-4591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-28
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty