NPI | 1245006311 |
---|---|
Doing Business As | LIVEWELL CLINICS |
Entity Type | Organization |
Authorized Contact | RUSSELL MARS HOWERTON Sr VP Network Phys & Hscmo 336-716-1331 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Enumeration Date | 2023-11-30 |
Last Update Date | 2023-12-05 |