Healthcare Provider Details

I. General information

NPI: 1235098195
Provider Name (Legal Business Name): LIVIN THE WELLNESS CO. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 W MIDWEST AVE
CASPER WY
82601-2429
US

IV. Provider business mailing address

232 E 2ND ST STE 101
CASPER WY
82601-2578
US

V. Phone/Fax

Practice location:
  • Phone: 307-258-8380
  • Fax:
Mailing address:
  • Phone: 307-258-8380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: BRIANNE RODRICK
Title or Position: OWNER
Credential:
Phone: 307-258-8380