Provider Demographics
NPI:1336963602
Name:LIVING ROOTS CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:LIVING ROOTS CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSHEARS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:903-439-5440
Mailing Address - Street 1:520 DAVIS ST S
Mailing Address - Street 2:
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75482-4021
Mailing Address - Country:US
Mailing Address - Phone:903-439-5440
Mailing Address - Fax:903-785-7492
Practice Address - Street 1:520 DAVIS ST S
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-4021
Practice Address - Country:US
Practice Address - Phone:903-439-5440
Practice Address - Fax:903-785-7492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-13
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty