# BREATH OF LIFE WELLNESS CENTER

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

## Provider details

- **NPI number:** 1972780690
- **Authorized official:** NICOLE MCCAULEY DC (OWNER)
- **Authorized official phone:** (417) 883-1141

## Contact information

- **Practice address:** 2021 S WAVERLY AVE, SUITE 500, SPRINGFIELD, MO 65804-2414
- **Practice address phone:** (417) 883-1141
- **Practice address fax:** (417) 889-6627
- **Mailing address:** 2021 S. WAVERLY, SUITE 500, SPRINGFIELD, MO 65804
- **Mailing address phone:** (417) 883-1141
- **Mailing address fax:** (417) 889-6627

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251300000X | Local Education Agency (LEA) | 2005007366 | MO | Yes |

## Other

- **Enumeration date:** 01/24/2008
- **Last updated:** 01/24/2008