Organization
YOUR BEST LIFE MEDICAL ECLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE LYN LATTIMER FNP (OWNER/NURSE PRACTITIONER)
(804) 554-2272
Entity
Organization
Contact information
Practice address
3905 PEGASI RD, HENRICO, VA 23231-2433
(804) 554-2272
(949) 577-4491
Mailing address
3905 PEGASI RD, HENRICO, VA 23231-2433
(804) 554-2272
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568904399
—
VA
Enumeration date
01/16/2023
Last updated
01/16/2023
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