Lively, John S

Lively, John S is an individual health care provider with primary practice located at 2710 Broadway Ext , Parkersburg WV 26101-6856. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Lively, John S can be contacted via phone (304) 485-0106.

Contact Information

Primary practice address
2710 Broadway Ext Parkersburg WV 26101-6856
Phone: (304) 485-0106
Fax: (304) 485-5671
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 632 West Virginia

Profile Details

NPI number 1699721795
LBN Legal business name Lively, John S
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699721795 NPPES
West Virginia Other 1035106 WORKERS COMP
West Virginia Other 5630092 WORKERS COMP
West Virginia MEDICAID 0132099000 WORKERS COMP

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