Provider Demographics
NPI:1285742825
Name:LIVINGSTON, DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:LIVINGSTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15127 JOG RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-1251
Mailing Address - Country:US
Mailing Address - Phone:561-496-4557
Mailing Address - Fax:561-495-2524
Practice Address - Street 1:15127 JOG RD
Practice Address - Street 2:SUITE 210
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-1251
Practice Address - Country:US
Practice Address - Phone:561-496-4557
Practice Address - Fax:561-495-2524
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7126111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU63993Medicare UPIN