# LIFE UNLIMITED, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609466044
- **Authorized official:** RAQUEL MCCORVEY FNP (FAMILY NURSE PRACTITIONER)
- **Authorized official phone:** (337) 212-4122

## Contact information

- **Practice address:** 349 MARYVIEW FARM ROAD, LAFAYETTE, LA 70507, LAFAYETTE, LA 70507
- **Practice address phone:** (337) 212-4122
- **Practice address fax:** (337) 237-2431
- **Mailing address:** 349 MARYVIEW FARM ROAD, LAFAYETTE, LA 70507, LAFAYETTE, LA 70507
- **Mailing address phone:** (337) 212-4122

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/20/2021
- **Last updated:** 01/20/2021