Lifestyle Wellness Center, LLC
Organization Active NPI Nutrition Chiropractor · Pineville, MO
NPI 1790811784 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1790811784
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nutrition Chiropractor 111NN1001X
- License
- 003822 (MO)
- Legal business name
- LIFESTYLE WELLNESS CENTER, LLC
- Practice address
- 307 Main Street
Pineville, MO 64856 - Phone
- (417) 223-4103
- NPI assigned
- Feb 26, 2007
- Organization subpart
- No
Authorized official
- Name
- Lesli G Smith
- Title
- Managing Member
- Phone
- (417) 223-4103
Corporate family (same tax ID) 1
Practitioners 1
National Provider Directory
- Tax ID family
- Lifestyle Wellness Center LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Chiropractor |
111NN1001X | 003822 | MO | Yes |
Addresses
Primary practice location
307 Main Street
Pineville, MO 64856
Mailing address
PO Box 37
Pineville, MO 64856-0037
Phone (417) 223-4103
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2106860001 | Other | MO | BLUE CROSS BLUE SHIELD |
Other providers in Pineville, MO
- Kylie Marie Helm
- Megan Nicole Knox
- Diane Marie Kunkel
- Judith G Lewallen
- Lifestyle Wellness Center LLC
- Kayla Nicole Loving
- Rachael Gabriela McCann
- Gilbert R Morgan
- Gary David Neymeyer
- Tony Hieu Nguyen
All providers in Pineville, MO · Nutrition Chiropractor in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.