Provider Demographics
NPI:1508059130
Name:LIVE WELL CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:LIVE WELL CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:814-624-0606
Mailing Address - Street 1:1634 QUAKER VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:NEW PARIS
Mailing Address - State:PA
Mailing Address - Zip Code:15554-8509
Mailing Address - Country:US
Mailing Address - Phone:814-624-0606
Mailing Address - Fax:814-624-2455
Practice Address - Street 1:1634 QUAKER VALLEY RD
Practice Address - Street 2:
Practice Address - City:NEW PARIS
Practice Address - State:PA
Practice Address - Zip Code:15554-8509
Practice Address - Country:US
Practice Address - Phone:814-624-0606
Practice Address - Fax:814-624-2455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-007841-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA115817Medicare PIN