Provider Demographics
NPI:1174712731
Name:LIVING HEALTH CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:LIVING HEALTH CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROWEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:PFEIFER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:615-373-3345
Mailing Address - Street 1:1608 WESTGATE CIRCLE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-9107
Mailing Address - Country:US
Mailing Address - Phone:615-373-3345
Mailing Address - Fax:615-373-3358
Practice Address - Street 1:1608 WESTGATE CIRCLE
Practice Address - Street 2:SUITE 100
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-9107
Practice Address - Country:US
Practice Address - Phone:615-373-3345
Practice Address - Fax:615-373-3358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC 554111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3673973Medicaid
TN3379952Medicare PIN