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General NPI Number Information
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NPI Number | 1982155263
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Entity Type | Organization
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Legal Business Name | LIVANTA MEDICAL CENTER
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Dates
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Enumeration Date | 10/20/2016
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Last Update Date | 07/18/2018
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Provider Practice Location Address
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Address Line | 2105 CATAWBA VALLEY BLVD SE
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City | HICKORY
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State | NC
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Zip | 28602
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Country | US
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Telephone | 828-358-0000
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Fax | 828-544-8284
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Provider Business Mailing Address
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Address Line | 2105 CATAWBA VALLEY BLVD SE
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City | HICKORY
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State | NC
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Zip | 28602-4151
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Country | US
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Telephone | 828-358-0000
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Fax | 828-544-8284
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Authorized Official
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Title or Position | OWNER
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Name | DALAN D GARCIA
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Credential | PA
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Telephone | 909-631-7501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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