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General NPI Number Information
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NPI Number | 1700476488
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Entity Type | Organization
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Legal Business Name | PHYSICIANS AT ENID LIVE WELL, LLP
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Dates
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Enumeration Date | 01/26/2021
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 3126 CLAIREMONT
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City | ENID
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State | OK
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Zip | 73703-1513
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Country | US
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Telephone | 580-233-4300
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Fax | 580-350-6401
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Provider Business Mailing Address
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Address Line | 3126 CLAIREMONT
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City | ENID
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State | OK
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Zip | 73703-1513
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Country | US
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Telephone | 580-233-4300
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Fax | 580-350-6401
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Authorized Official
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Title or Position | CEO
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Name | DR. VIKI SHARLAINE RESLER
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Credential | D.C.
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Telephone | 580-233-4300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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