Provider Demographics
NPI:1194048611
Name:LIVERMORE, KENT EDWARD (DVM)
Entity type:Individual
Prefix:DR
First Name:KENT
Middle Name:EDWARD
Last Name:LIVERMORE
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7435 W CACTUS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-5300
Mailing Address - Country:US
Mailing Address - Phone:623-878-0033
Mailing Address - Fax:623-878-8037
Practice Address - Street 1:7435 W CACTUS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-5300
Practice Address - Country:US
Practice Address - Phone:623-878-0033
Practice Address - Fax:623-878-8037
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1125174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian