Provider Demographics
NPI:1154292878
Name:LIVE BIG & LOUD LLC
Entity type:Organization
Organization Name:LIVE BIG & LOUD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:DUANE
Authorized Official - Last Name:MARQUARDT
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:810-531-8794
Mailing Address - Street 1:3915 PINE GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT GRATIOT
Mailing Address - State:MI
Mailing Address - Zip Code:48059-4251
Mailing Address - Country:US
Mailing Address - Phone:810-531-8794
Mailing Address - Fax:
Practice Address - Street 1:3915 PINE GROVE AVE
Practice Address - Street 2:
Practice Address - City:FORT GRATIOT
Practice Address - State:MI
Practice Address - Zip Code:48059-4251
Practice Address - Country:US
Practice Address - Phone:810-531-8794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WELLNESS WORKS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-09-16
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty