=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558669598
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LIVINGSTON CHIROPRACTIC CLINIC P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/28/2011
-----------------------------------------------------
Last Update Date | 02/28/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1037 WEST MAIN STREET SUITE D
-----------------------------------------------------
City | LEBANON
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37087-3356
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-453-9300
-----------------------------------------------------
Fax | 615-453-9307
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1037 WEST MAIN STREET SUITE D
-----------------------------------------------------
City | LEBANON
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37087-3356
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-453-9300
-----------------------------------------------------
Fax | 615-453-9307
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | DR. STEVEN GENE LIVINGSTON
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 615-453-9300
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | DC0000001803
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------