| NPI | 1992412266 |
|---|---|
| Doing Business As | LIVE WELL AT CITI - O'FALLON |
| Entity Type | Organization |
| Authorized Contact | WILLIAM WRIGHT Legal Counsel 615-577-5893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2022-11-04 |
| Last Update Date | 2022-11-04 |