Provider Demographics
NPI:1861151672
Name:100 CHIRO LIVINGOOD VENENGA PC PLLC
Entity type:Organization
Organization Name:100 CHIRO LIVINGOOD VENENGA PC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PC
Authorized Official - Prefix:
Authorized Official - First Name:DR BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVINGOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-217-0895
Mailing Address - Street 1:9227 E LINCOLN AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5504
Mailing Address - Country:US
Mailing Address - Phone:719-217-0895
Mailing Address - Fax:
Practice Address - Street 1:9227 E LINCOLN AVE STE 300
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5504
Practice Address - Country:US
Practice Address - Phone:720-535-6188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-09
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty