Provider Demographics
NPI:1730828112
Name:PHYSICIANS AT ENID LIVE WELL, LLP
Entity type:Organization
Organization Name:PHYSICIANS AT ENID LIVE WELL, LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:VIKI
Authorized Official - Middle Name:SHARLAINE
Authorized Official - Last Name:RESLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC, RN
Authorized Official - Phone:580-233-4300
Mailing Address - Street 1:3126 CLAIREMONT
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-1513
Mailing Address - Country:US
Mailing Address - Phone:580-233-4300
Mailing Address - Fax:580-350-6401
Practice Address - Street 1:3126 CLAIREMONT
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-1513
Practice Address - Country:US
Practice Address - Phone:580-233-4300
Practice Address - Fax:580-350-6401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty