| NPI | 1568772952 |
|---|---|
| Other Name | LIFESTYLE WELLNESS ENTERPRISE, PLLC |
| Entity Type | Organization |
| Authorized Contact | JOHNETTA MINER CEO/President 1718-379-1290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: NY F420329-1) |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2010-10-19 |