Provider Demographics
NPI:1881782159
Name:MOLIVER, SETH LOREN (DC)
Entity type:Individual
Prefix:DR
First Name:SETH
Middle Name:LOREN
Last Name:MOLIVER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:624 JETTON ST
Mailing Address - Street 2:SUITE 260
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-9315
Mailing Address - Country:US
Mailing Address - Phone:704-896-3435
Mailing Address - Fax:704-896-3424
Practice Address - Street 1:624 JETTON ST
Practice Address - Street 2:SUITE 260
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-9315
Practice Address - Country:US
Practice Address - Phone:704-896-3435
Practice Address - Fax:704-896-3424
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYX0009818-1111N00000X
NC3526111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor