Provider Demographics
NPI:1831367440
Name:LIVINGSTON, DAVID C (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
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 1:56 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-1517
Mailing Address - Country:US
Mailing Address - Phone:419-668-5147
Mailing Address - Fax:419-668-5147
Practice Address - Street 1:56 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-1517
Practice Address - Country:US
Practice Address - Phone:419-668-5147
Practice Address - Fax:419-668-5147
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-16
Last Update Date:2008-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH266111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0105424Medicaid
OH0387951Medicare PIN
T46492Medicare UPIN