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Organization
MED SPA AT ENID LIVE WELL
Active
Organization
MED SPA AT ENID LIVE WELL
Active
Parent organization
VIKI WHITE
Other names
Enid Live Well
Organization subpart
Yes
Provider details
NPI number
Legal business name
VIKI WHITE
Authorized official
DR. VIKI SHARLAIN WHITE DC (CEO)
(580) 233-4300
Entity
Organization
Contact information
Practice address
2111 N VAN BUREN ST, ENID, OK 73703-2524
(580) 233-4300
(580) 350-6401
Mailing address
2111 N VAN BUREN ST, ENID, OK 73703-2524
(580) 233-4300
(580) 350-6401
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
NULL
207N00000X
Dermatology Physician
—
—
207ND0900X
Dermatopathology Physician
—
NULL
207ND0900X
Dermatopathology Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
NULL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
NULL
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
261QP3300X
Pain Clinic/Center
—
NULL
Other
Enumeration date
02/03/2020
Last updated
11/11/2020
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