Healthcare Provider Details

I. General information

NPI: 1730335225
Provider Name (Legal Business Name): LIVE WELL CHIROPRACTIC , P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2008
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3384 W 4600 S STE 1
WEST HAVEN UT
84401-9222
US

IV. Provider business mailing address

3384 W 4600 S STE 1
WEST HAVEN UT
84401-9222
US

V. Phone/Fax

Practice location:
  • Phone: 801-731-9899
  • Fax: 801-731-9897
Mailing address:
  • Phone: 801-731-9899
  • Fax: 801-731-9897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. BRIAN TOLMAN
Title or Position: OWNER
Credential: DO
Phone: 801-731-9899