MEDICARE: 100 CHIRO FORT WORTH PLLC

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
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1629839162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	100 CHIRO FORT WORTH PLLC

Provider Business Mailing Address
First Line	:	20551 N PIMA RD STE 100
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85255-9154
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3251 TRACEWOOD WAY STE 121
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-1747
Country	:	US
Telephone Number	:	719-217-0895
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BRANDON LIVINGOOD
Credential	:	DC
Telephone Number	:	719-217-0895

Provider Enumeration Date	:	01/22/2024
Last Update Date	:	01/22/2024

Similar Medicare Providers

1780168716 — DR. COREY NICHOLAS STRUNK DC
Practice Location Address:

3251 TRACEWOOD WAY STE 121
FORT WORTH, TX
76177-1747

Practice Phone: 817-886-9600
Practice Fax:

1497544415 — 100 CHIRO ADRY 1 LLC
Practice Location Address:

3251 TRACEWOOD WAY STE 121
FORT WORTH, TX
76177-1747

Practice Phone: 817-886-9600
Practice Fax:

1164309241 — SUNU JOSEPH KWON DC
Practice Location Address:

3251 TRACEWOOD WAY STE 121
FORT WORTH, TX
76177-1747

Practice Phone: 817-886-9600
Practice Fax:

1174858211 — MRS. KARRIE MALONEY
Practice Location Address:

3737 APPOMATTOX ST APT B
FORT IRWIN, CA
92310-1747

Practice Phone: 760-380-5724
Practice Fax: 760-380-2122

1912213588 — DAWN LESLEY ETZEL
Practice Location Address:

1747 N WELLS ST
FORT WAYNE, IN
46808-3235

Practice Phone: 260-420-6100
Practice Fax: 574-268-2377

1548539588 — EL AGATHE ASOPO TANYI ARNP
Practice Location Address:

1747 FORT SMITH BLVD
DELTONA, FL
32725-3728

Practice Phone: 202-834-7722
Practice Fax:

Directions to “100 CHIRO FORT WORTH PLLC ” Practice Location

Language	Start Address	Practice Location

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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.