Provider Demographics
NPI:1104053974
Name:LIVING WELL PAIN CENTER LLC
Entity type:Organization
Organization Name:LIVING WELL PAIN CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & LEAD PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MALIK
Authorized Official - Middle Name:BJ SINGH
Authorized Official - Last Name:PRIHAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-842-4929
Mailing Address - Street 1:1050 HILDEBRAND LN NE
Mailing Address - Street 2:STE-102
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-2863
Mailing Address - Country:US
Mailing Address - Phone:206-842-4929
Mailing Address - Fax:206-842-4920
Practice Address - Street 1:1050 HILDEBRAND LN NE
Practice Address - Street 2:STE-102
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-2863
Practice Address - Country:US
Practice Address - Phone:206-842-4929
Practice Address - Fax:206-842-4920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-18
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty