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Organization

LIVE HEALTHY PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHRISTOPHER PAUL MASSOGLIA SR. DC (PRESIDENT)
(651) 334-1290
Entity
Organization

Contact information

Practice address
7300 147TH ST W, UNIT 304, APPLE VALLEY, MN 55124-7541
(952) 431-5330
(651) 528-6882
Mailing address
7300 147TH ST W, UNIT 304, APPLE VALLEY, MN 55124-7541
(952) 431-5330
(651) 528-6882

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2728
MN
111NS0005X
Sports Physician Chiropractor
2728
MN
207QA0401X
Addiction Medicine (Family Medicine) Physician
43602
MN
207QA0505X
Adult Medicine Physician
Primary
43602
MN

Other

Enumeration date
09/02/2015
Last updated
02/26/2016
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