| Live.well Llc | |
|
517 Fairmont Ave Fairmont WV 26554-5101 | |
| (304) 612-8860 | |
| Not Available |
| Full Name | Live.well Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 517 Fairmont Ave, Fairmont, West Virginia |
| Authorized Official Name and Position | Denise Tonkin (OWNER) |
| Authorized Official Contact | 3046128860 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Live.well Llc 1 Hidden Trl Fairmont WV 26554-8822 Ph: (304) 612-8860 | Live.well Llc 517 Fairmont Ave Fairmont WV 26554-5101 Ph: (304) 612-8860 |
| NPI Number | 1275076374 |
|---|---|
| Provider Enumeration Date | 11/22/2016 |
| Last Update Date | 11/22/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275076374 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2008 (West Virginia) | Primary |
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