Annual report pursuant to Section 13 and 15(d)

Nature of Operations and Summary of Significant Accounting Policies - Clinics in Operation Under Franchise Agreements or Company-Owned or Managed (Details)

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Nature of Operations and Summary of Significant Accounting Policies - Clinics in Operation Under Franchise Agreements or Company-Owned or Managed (Details) - clinic
 12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Product Information, Franchised Clinics, Company-Owned Or Managed Clinics, Activity [Roll Forward]    
Clinics open at beginning of period 706  
Clinics in operation at the end of the period 838 706
Clinic licenses sold but not yet developed 197 245
Executed letters of intent for future clinic licenses 38 38
Franchised Clinics    
Product Information, Franchised Clinics, Company-Owned Or Managed Clinics, Activity [Roll Forward]    
Clinics open at beginning of period 610 515
Opened during the period 121 110
Acquired during the period 2 0
Sold during the period (16) (12)
Closed during the period (5) (3)
Clinics in operation at the end of the period 712 610
Company-Owned or Managed Clinics    
Product Information, Franchised Clinics, Company-Owned Or Managed Clinics, Activity [Roll Forward]    
Clinics open at beginning of period 96 64
Opened during the period 16 20
Acquired during the period 16 12
Sold during the period (2) 0
Closed during the period 0 0
Clinics in operation at the end of the period 126 96