Provider Demographics
NPI:1982748281
Name:LIVINGSTON, JOHN K (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:K
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 1:25111 MILES RD STE D
Mailing Address - Street 2:
Mailing Address - City:WARRENSVILLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5419
Mailing Address - Country:US
Mailing Address - Phone:440-528-0005
Mailing Address - Fax:440-528-0011
Practice Address - Street 1:25111 MILES RD STE D
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-5419
Practice Address - Country:US
Practice Address - Phone:440-528-0005
Practice Address - Fax:440-528-0011
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2124111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0151022Medicaid
OH0103435Medicaid