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Organization

LIVING4LIFE WELLNESSLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DONISS L HICKS RD (PRESIDENT/WELLNESS SPECIALIST)
(313) 618-7454
Entity
Organization

Contact information

Practice address
11085 MCKINNEY ST, DETROIT, MI 48224-1112
(313) 618-7454
Mailing address
PO BOX 241603, DETROIT, MI 48224-5603
(313) 618-7454

Taxonomy

Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
812531
MI

Other

Enumeration date
02/04/2015
Last updated
02/04/2015
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