Provider Demographics
NPI:1013598531
Name:BEST LIFE WELLNESS, LLC
Entity Type:Organization
Organization Name:BEST LIFE WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:GUNTER
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:864-341-1152
Mailing Address - Street 1:5 FOREST GLENN CT
Mailing Address - Street 2:
Mailing Address - City:PELZER
Mailing Address - State:SC
Mailing Address - Zip Code:29669-8960
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5 FOREST GLENN CT
Practice Address - Street 2:
Practice Address - City:PELZER
Practice Address - State:SC
Practice Address - Zip Code:29669-8960
Practice Address - Country:US
Practice Address - Phone:864-341-1152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care