Provider Demographics
NPI:1144180985
Name:LIVELY LIVE BETTER
Entity type:Organization
Organization Name:LIVELY LIVE BETTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:DUCKETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-259-0375
Mailing Address - Street 1:949 ORIOLE DR SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30311-2422
Mailing Address - Country:US
Mailing Address - Phone:919-259-0375
Mailing Address - Fax:
Practice Address - Street 1:949 ORIOLE DR SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30311-2422
Practice Address - Country:US
Practice Address - Phone:919-259-0375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-14
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty