Individual
KELSEY BLOCH LIVENGOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
32 S PINE ST, SUITE 1, CABOT, AR 72023-3830
(713) 306-2422
Mailing address
PO BOX 28, CABOT FAMILY CARE, CABOT, AR 72023-0028
(713) 306-2422
(501) 843-2599
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2640
AR
152W00000X
Optometrist
2889
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2889
STATE OF TENNESSEE DEPARTMENT OF HEALTH
TN
01
—
AR2640
STATE BOARD OF OPTOMETRY
AR
Enumeration date
04/20/2009
Last updated
01/10/2014
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