Organization
PREMISE HEALTH OF WEST VIRGINIA MEDICAL, MEDICAL CORPORATION
Active
Other names
L & N LivingWell Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON LEIZMAN MD (PRESIDENT)
(216) 479-9063
Entity
Organization
Contact information
Practice address
908 W BROADWAY FL 8, LOUISVILLE, KY 40203
(502) 779-6015
(502) 589-5258
Mailing address
5500 MARYLAND WAY STE 120, BRENTWOOD, TN 37027-4993
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
05/18/2018
Last updated
08/15/2022
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