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Organization
MIND BODY ENDURANCE LLC
Active
Organization
MIND BODY ENDURANCE LLC
Active
Other names
Mind Body Endurance LLC
Organization subpart
No
Provider details
NPI number
Authorized official
RILEY NICKOLS PHD (OWNER)
(513) 505-2160
Entity
Organization
Contact information
Practice address
16 N GORE AVE STE 204, SAINT LOUIS, MO 63119-2315
(513) 505-2160
Mailing address
16 N GORE AVE STE 204, SAINT LOUIS, MO 63119-2315
(513) 505-2160
Taxonomy
Speciality
Code
Description
License number
State
103TE1100X
Exercise & Sports Psychologist
Primary
—
NULL
103TE1100X
Exercise & Sports Psychologist
Primary
—
—
Other
Enumeration date
02/10/2023
Last updated
02/10/2023
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