| Ilivewell Nutrition Therpay, Llc | |
|
801 Ranch Road 620 S Lakeway TX 78734-5316 | |
| (512) 547-9274 | |
| Not Available |
| Full Name | Ilivewell Nutrition Therpay, Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 801 Ranch Road 620 S, Lakeway, Texas |
| Authorized Official Name and Position | Adrien Paczosa (PRESIDENT) |
| Authorized Official Contact | 5125479274 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ilivewell Nutrition Therpay, Llc 801 Ranch Road 620 S Lakeway TX 78734-5316 Ph: () - | Ilivewell Nutrition Therpay, Llc 801 Ranch Road 620 S Lakeway TX 78734-5316 Ph: (512) 547-9274 |
| NPI Number | 1306273347 |
|---|---|
| Provider Enumeration Date | 10/05/2013 |
| Last Update Date | 10/05/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306273347 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | DT82817 (Texas) | Primary |
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