Healthcare Provider Details

I. General information

NPI: 1144180985
Provider Name (Legal Business Name): LIVELY LIVE BETTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2025
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

949 ORIOLE DR SW
ATLANTA GA
30311-2422
US

IV. Provider business mailing address

949 ORIOLE DR SW
ATLANTA GA
30311-2422
US

V. Phone/Fax

Practice location:
  • Phone: 919-259-0375
  • Fax:
Mailing address:
  • Phone: 919-259-0375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LORI DUCKETT
Title or Position: OWNER
Credential: MD
Phone: 919-259-0375