Provider Demographics
NPI:1902074495
Name:HEALTHY LIVING CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:HEALTHY LIVING CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SADIYQ
Authorized Official - Middle Name:N
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:709-837-9933
Mailing Address - Street 1:299 COMMERCE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30241-2345
Mailing Address - Country:US
Mailing Address - Phone:706-837-9933
Mailing Address - Fax:
Practice Address - Street 1:299 COMMERCE AVE STE B
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30241-2345
Practice Address - Country:US
Practice Address - Phone:706-837-9933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty