Organization
LIVE WELL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SISSY TEZERA DC (OWNER)
(248) 809-2094
Entity
Organization
Contact information
Practice address
15565 NORTHLAND DR, SUITE 103W-B, SOUTHFIELD, MI 48075
(248) 809-2094
Mailing address
15565 NORTHLAND DR, SUITE 103W-B, SOUTHFIELD, MI 48075
(248) 809-2094
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
01/19/2016
Last updated
01/19/2016
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