Live Well Center

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6654 Issued in MN

Legal business name

LIVE WELL CENTER

Practice address

315 E River Rd
Brainerd, MN 56401-3503

Phone

(218) 454-5483

NPI assigned

Oct 23, 2015

Organization subpart

Yes

Parent organization

LIVE WELL CENTERAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

James Davis

Title

Owner

Phone

(218) 330-9830

Specialties & licenses 1

Addresses

Part of

Live Well Center

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1445558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445558400000",
    "number": "1477925998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 E RIVER RD",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013503",
            "telephone_number": "218-454-5483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E RIVER RD",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013503",
            "telephone_number": "218-454-5483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE WELL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIVE WELL CENTER",
        "enumeration_date": "2015-10-23",
        "last_updated": "2015-10-23",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-330-9830"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "6654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hong Li, MD
• Jesse Alan Lind
• Holly Jean Line, LPCC
• Michelle Lipp, RN
• Jeanette Frances Listul, PTA
• Live Well Chiropractic
• Suzanne Marie Lokken
• Pauline Ann Long, RN
• Alicia R Lorensen, APRN,CNP
• Chenise R Lozancic, PHARMD

• Physical Therapist in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.