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NPI Code Detail

MEDICARE: LIVE WELL CHIROPRACTIC

MEDICARE: LIVE WELL CHIROPRACTIC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor3698OR

General Provider Information

NPI Number : 1629316708
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIVE WELL CHIROPRACTIC
Provider Business Mailing Address
First Line : 20229 HIGHWAY 213
Second Line :
City : OREGON CITY
State : OR
Zip : 97045-9069
Country : US
Telephone Number : 503-342-2719
Fax Number : 503-305-3263
Provider Business Practice Location Address
First Line : 20229 HIGHWAY 213
Second Line :
City : OREGON CITY
State : OR
Zip : 97045-9069
Country : US
Telephone Number : 503-342-2719
Fax Number : 503-305-3263
Authorized Official
Title or Position : OWNER
Name : NATHAN EDMONDS
Credential :
Telephone Number : 503-342-2719
Provider Enumeration Date : 01/23/2013
Last Update Date : 01/23/2013

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Directions to “LIVE WELL CHIROPRACTIC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.