# MIND BODY ENDURANCE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mind Body Endurance LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053018903
- **Authorized official:** RILEY NICKOLS PHD (OWNER)
- **Authorized official phone:** (513) 505-2160

## Contact information

- **Practice address:** 16 N GORE AVE STE 204, SAINT LOUIS, MO 63119-2315
- **Practice address phone:** (513) 505-2160
- **Mailing address:** 16 N GORE AVE STE 204, SAINT LOUIS, MO 63119-2315
- **Mailing address phone:** (513) 505-2160

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TE1100X | Exercise & Sports Psychologist | — | NULL | Yes |
| 103TE1100X | Exercise & Sports Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 02/10/2023
- **Last updated:** 02/10/2023