Live Well Chiropractic PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH1282 Issued in GA

Legal business name

LIVE WELL CHIROPRACTIC PA

Practice address

140 Bridges Rd
Suite a
Mauldin, SC 29662-3259

Phone

(864) 627-4325

Fax

(864) 627-7733

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Manuel A Izquierdo, D.C.NPI 1225063662

Title

President

Phone

(864) 627-4325

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: manuel@lwc0003.direct.chirotouch.md

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Manuel Alberto Izquierdo, DC

  • Chiropractor
  • Mauldin, SC
  • NPI 1225063662
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360108800000",
    "number": "1932323128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 BRIDGES RD",
            "address_2": "SUITE A",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296623259",
            "telephone_number": "864-627-4325",
            "fax_number": "864-627-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BRIDGES RD",
            "address_2": "SUITE A",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296623259",
            "telephone_number": "864-627-4325",
            "fax_number": "864-627-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE WELL CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2013-02-06",
        "status": "A",
        "authorized_official_last_name": "IZQUIERDO",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-627-4325",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CH1282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH1282",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. MANUEL A. IZQUIERDO",
            "identifier": "1225063662",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Brad A. Lindstrom, DPM
• Little Learners Academy
• Kristin Marie Long, PHARMD
• Lesley D Looper, PA
• Ellen Ludwig
• Torrin Charles Lundberg, DPM
• Laura M Maganini, SLP

• Chiropractor in Mauldin, SC
• Providers in Mauldin, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.