Organization
LIVE WELL CENTER
Active
Parent organization
LIVE WELL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIVE WELL CENTER
Authorized official
JAMES DAVIS (OWNER)
(218) 330-9830
Entity
Organization
Contact information
Practice address
315 E RIVER RD, BRAINERD, MN 56401-3503
(218) 454-5483
Mailing address
315 E RIVER RD, BRAINERD, MN 56401-3503
(218) 454-5483
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6654
MN
Other
Enumeration date
10/23/2015
Last updated
10/23/2015
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