Healthcare Provider Details

I. General information

NPI: 1396602637
Provider Name (Legal Business Name): LIV WELL CHIROPRACTIC, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2146 S RIVERSIDE DR STE 5
EDGEWATER FL
32141-4257
US

IV. Provider business mailing address

2146 S RIVERSIDE DR STE 5
EDGEWATER FL
32141-4257
US

V. Phone/Fax

Practice location:
  • Phone: 386-222-0210
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. OLIVIA EVANS
Title or Position: OWNER
Credential: D.C.
Phone: 386-222-0210