Organization
LIVE WELL: UPSTATE CENTER FOR NATURAL HEALTH LLC
Active
Other names
Live Well Upstate
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SEAMUS DEAN KENNEDY LAC (LICENSED ACUPUNCTURIST)
(607) 733-3373
Entity
Organization
Contact information
Practice address
408 W CHURCH ST, ELMIRA, NY 14901-2603
(607) 733-3373
Mailing address
408 W CHURCH ST, ELMIRA, NY 14901-2603
(607) 733-3373
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
004530-1
NY
171100000X
Acupuncturist
005959
NY
225700000X
Massage Therapist
016490-1
NY
225700000X
Massage Therapist
029330
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184137085
N/A
NY
01
—
1912273574
N/A
NY
Enumeration date
12/05/2017
Last updated
12/05/2017
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