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1558141606
LIFE REIMAGINED LLC
SPARTA, TN
NPI
1558141606
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Entity Type
Organization
Authorized Contact
KIMBERLY A SPIVEY
Owner
931-345-3968
Organization Subpart ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
Enumeration Date
2023-10-04
Last Update Date
2023-10-10
Business Address
LIFE REIMAGINED LLC
3380 WALNUT GROVE RD
SPARTA, TN 38583-5365
Phone number: 931-345-3968
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Mailing Address
LIFE REIMAGINED LLC
5247 VILLAGE RD
COOKEVILLE, TN 38506-7179
Phone number: 931-345-3968
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