Organization
LIVWELL CLINIC PLLC
Active
Other names
LivWell Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA DENISE GOODWIN MD (OWNER AND MEDICAL DIRECTOR)
(607) 434-2102
Entity
Organization
Contact information
Practice address
4715 24TH PL, MERIDIAN, MS 39305-1686
(601) 696-6736
Mailing address
6500 RIVER PLACE BLVD, BLDG 4 STE 102, AUSTIN, TX 78730-1120
(607) 434-2102
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
08/17/2023
Last updated
08/17/2023
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