Provider Demographics
NPI:1801567326
Name:LIVE4 INC
Entity type:Organization
Organization Name:LIVE4 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, ATC
Authorized Official - Phone:978-274-2090
Mailing Address - Street 1:525 MASSACHUSETTS AVE STE 206B
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-2963
Mailing Address - Country:US
Mailing Address - Phone:978-274-2090
Mailing Address - Fax:
Practice Address - Street 1:525 MASSACHUSETTS AVE STE 206B
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-2963
Practice Address - Country:US
Practice Address - Phone:978-274-2090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy