# LIVE WELL MEDICAL CLINIC & SPA

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

## Provider details

- **NPI number:** 1902208903
- **Authorized official:** HEATHER WILSON FNP-BC (OWNER)
- **Authorized official phone:** (931) 839-6642

## Contact information

- **Practice address:** 117 W COMMERCIAL AVE, MONTEREY, TN 38574-1107
- **Practice address phone:** (931) 839-6642
- **Practice address fax:** (931) 839-6643
- **Mailing address:** 117 W COMMERCIAL AVE, MONTEREY, TN 38574-1107
- **Mailing address phone:** (931) 839-6642
- **Mailing address fax:** (931) 839-6643

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QH0100X | Health Service Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 09/22/2014
- **Last updated:** 06/17/2026