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General NPI Number Information
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NPI Number | 1831800598
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Entity Type | Organization
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Legal Business Name | LIVE WELL CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 12/13/2022
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Last Update Date | 08/18/2023
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Provider Practice Location Address
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Address Line | 136 STUTTS RD STE 3
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City | MOORESVILLE
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State | NC
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Zip | 28117-6403
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Country | US
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Telephone | 704-912-5050
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Fax |
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Provider Business Mailing Address
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Address Line | 253 ROYALTON RD
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City | MOORESVILLE
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State | NC
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Zip | 28115-6778
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Country | US
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Telephone | 516-712-5034
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. AUSTIN BUERGERMEISTER
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Credential | DC
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Telephone | 516-712-5034
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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 |
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License Number State |
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