Organization
ILIVEWELL NUTRITION THERPAY, LLC
Active
Organization
ILIVEWELL NUTRITION THERPAY, LLC
Active
Parent organization
PRACTICE FUSION
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRACTICE FUSION
Authorized official
ADRIEN PACZOSA (PRESIDENT)
(512) 547-9274
Entity
Organization
Contact information
Practice address
801 RANCH ROAD 620 S, LAKEWAY, TX 78734-5316
(512) 547-9274
Mailing address
801 RANCH ROAD 620 S, LAKEWAY, TX 78734-5316
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
DT82817
TX
Other
Enumeration date
10/05/2013
Last updated
10/05/2013
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