Organization
LIVWELL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HALEY BUICE (PRACTICE MANAGE)
(706) 668-5140
Entity
Organization
Contact information
Practice address
210 W BROOME ST, LAGRANGE, GA 30240-3102
(706) 668-5140
(706) 668-5142
Mailing address
210 W BROOME ST, LAGRANGE, GA 30240-3102
(706) 668-5140
(706) 668-5142
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
11/17/2022
Last updated
03/06/2023
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