Organization Active NPI

Living Well Chiropractic, P.C.

  • Chiropractor
  • Plymouth, MN
National Provider Identifier
1598068439
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4513 Issued in MN
Legal business name
LIVING WELL CHIROPRACTIC, P.C.
Practice address
3140 Harbor LN N
Suite #102
Plymouth, MN 55447-5126
Phone
(763) 230-7333
Fax
(763) 230-7335
NPI assigned
Dec 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jeffrey C Leach, D.C.
Title
Chiropractor
Phone
(763) 230-7333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4513 MN Primary

Addresses

Primary practice location

3140 Harbor LN N
Suite #102
Plymouth, MN 55447-5126

Mailing address

3140 Harbor Lane N.
Suite #102
Plymouth, MN 55447-5118
Phone (763) 230-7333

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292371200000",
    "number": "1598068439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 HARBOR LANE N.",
            "address_2": "SUITE #102",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554475118",
            "telephone_number": "763-230-7333",
            "fax_number": "763-230-7335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3140 HARBOR LN N",
            "address_2": "SUITE #102",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554475126",
            "telephone_number": "763-230-7333",
            "fax_number": "763-230-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL CHIROPRACTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-15",
        "last_updated": "2010-12-15",
        "status": "A",
        "authorized_official_last_name": "LEACH",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "763-230-7333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.