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General NPI Number Information
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NPI Number | 1417243080
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Entity Type | Organization
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Legal Business Name | LIVE WELL CHIROPRACTIC CARE LLC
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Dates
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Enumeration Date | 06/22/2011
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Last Update Date | 03/07/2014
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Provider Practice Location Address
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Address Line | 33 CHURCH HILL RD
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City | NEWTOWN
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State | CT
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Zip | 06470-1612
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Country | US
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Telephone | 203-270-6300
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Fax | 203-724-0383
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Provider Business Mailing Address
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Address Line | 33 CHURCH HILL RD
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City | NEWTOWN
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State | CT
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Zip | 06470-1612
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Country | US
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Telephone | 203-270-6300
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Fax | 203-724-0383
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Authorized Official
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Title or Position | OWNER
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Name | DR. MEREDITH ANN ROSCO
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Credential | D.C.
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Telephone | 203-994-4541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 001884
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License Number State | CT
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