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Organization
LIVE WELL CENTER
Active
Organization
LIVE WELL CENTER
Active
Parent organization
LIVE WELL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIVE WELL CENTER
Authorized official
JAMES DAVIS (OWNER)
(218) 330-9830
Entity
Organization
Contact information
Practice address
315 E RIVER RD, BRAINERD, MN 56401-3503
(218) 454-5483
Mailing address
315 E RIVER RD, BRAINERD, MN 56401-3503
(218) 454-5483
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6654
MN
Other
Enumeration date
10/23/2015
Last updated
10/23/2015
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