# LIVE WELL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LIVE WELL CENTER
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1477925998
- **Legal business name:** LIVE WELL CENTER
- **Authorized official:** JAMES DAVIS (OWNER)
- **Authorized official phone:** (218) 330-9830

## Contact information

- **Practice address:** 315 E RIVER RD, BRAINERD, MN 56401-3503
- **Practice address phone:** (218) 454-5483
- **Mailing address:** 315 E RIVER RD, BRAINERD, MN 56401-3503
- **Mailing address phone:** (218) 454-5483

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 6654 | MN | Yes |

## Other

- **Enumeration date:** 10/23/2015
- **Last updated:** 10/23/2015