10D2194006 CLIA NUMBER - BRETT D SCHOCH DC PA DBA LIVING WATERS WELLNESS

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Laboratory Demographics

CLIA Number: 10D2194006

Facility Name: BRETT D SCHOCH DC PA DBA LIVING WATERS WELLNESS

Facility Address:
2502 QUINCY AVE
FORT PIERCE, FL
ZIP 34947
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Facility Phone Number: 772 302-9580

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1174514376

Taxonomy: 111N00000X - Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

CLIA Record

Field Name	Field Value
CLIA Number	10D2194006
LAB Type	Physician Office
Facility Name	BRETT D SCHOCH DC PA DBA LIVING WATERS WELLNESS
Street	2502 QUINCY AVE
City	FORT PIERCE
State	FL
ZIP	34947
Phone	772 302-9580
CertificateType	4
CertificateEffectiveDate	9/28/2022
CertificateExpirationDate	9/27/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024