| NPI | 1013536663 |
|---|---|
| Doing Business As | LIVE. LOVE. WELLNESS MD |
| Entity Type | Organization |
| Authorized Contact | KATRINA LAKE Owner 708-308-8974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-05-01 |