Organization
LIVE WELL CHIROPRACTIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANUEL A IZQUIERDO D.C. (PRESIDENT)
(864) 627-4325
Entity
Organization
Contact information
Practice address
140 BRIDGES RD, SUITE A, MAULDIN, SC 29662-3259
(864) 627-4325
(864) 627-7733
Mailing address
140 BRIDGES RD, SUITE A, MAULDIN, SC 29662-3259
(864) 627-4325
(864) 627-7733
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH1282
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225063662
DR. MANUEL A. IZQUIERDO
SC
05
—
CH1282
—
SC
Enumeration date
04/12/2007
Last updated
02/06/2013
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