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Organization

LIVE WELL MEDICAL CLINIC & SPA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HEATHER WILSON FNP-BC (OWNER)
(931) 839-6642
Entity
Organization

Contact information

Practice address
117 W COMMERCIAL AVE, MONTEREY, TN 38574-1107
(931) 839-6642
(931) 839-6643
Mailing address
117 W COMMERCIAL AVE, MONTEREY, TN 38574-1107
(931) 839-6642
(931) 839-6643

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q007973
TN
Enumeration date
09/22/2014
Last updated
09/17/2025
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