Organization
LIBERTY HEALTH & WELLNESS LLC- FAYETTEVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINA ANNE MANUELE RN (OWNER/MANAGER)
(662) 417-5475
Entity
Organization
Contact information
Practice address
1816 HUNTSVILLE HWY STE C, FAYETTEVILLE, TN 37334-3787
(931) 297-2700
Mailing address
2564 LANNING RD, LAWRENCEBURG, TN 38464-7597
(662) 417-5475
(931) 231-3353
Taxonomy
Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
—
—
Other
Enumeration date
06/28/2019
Last updated
07/02/2019
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