# LIVEWELL CENTERS LTD

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

## Provider details

- **NPI number:** 1750793113
- **Authorized official:** DR. PATRICK BRYAN KOMESHAK DC (CHIEF OF STAFF)
- **Authorized official phone:** (618) 236-3600

## Contact information

- **Practice address:** 3030 FRANK SCOTT PKWY W, SUITE 1, BELLEVILLE, IL 62223-5014
- **Practice address phone:** (618) 236-3600
- **Mailing address:** 3030 FRANK SCOTT PKWY W, SUITE 1, BELLEVILLE, IL 62223-5014
- **Mailing address phone:** (618) 236-3600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/20/2014
- **Last updated:** 05/20/2014