Livengood, Kelsey Bloch
Livengood, Kelsey Bloch is an sole proprietor health care provider with primary practice located at 32 S Pine St Suite 1, Cabot AR 72023-3830. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Livengood, Kelsey Bloch can be contacted via phone (713) 306-2422.Contact Information
Primary practice address
32 S Pine St Suite 1
Cabot AR 72023-3830
Phone: (713) 306-2422
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2889 | Tennessee |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2640 | Arkansas |
Profile Details
| NPI number | 1619111762 |
|---|---|
| LBN Legal business name | Livengood, Kelsey Bloch |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 20th, 2009 |
| Last updated | Jan 10th, 2014 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619111762 | NPPES |
| Tennessee | Other | 2889 | STATE OF TENNESSEE DEPARTMENT OF HEALTH |
| Tennessee | Other | AR2640 | STATE OF TENNESSEE DEPARTMENT OF HEALTH |
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