LIFESTYLE PERFORMANCE MEDICINE NPI 1922451376

NPI Information

LIFESTYLE PERFORMANCE MEDICINE is a specialist in Orange Beach, AL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. LIFESTYLE PERFORMANCE MEDICINE NPI is 1922451376. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Regenesis Llc.

The provider's business location address is:

24847 COMMERCIAL AVE
ORANGE BEACH, AL
ZIP 36561-845
Phone: (251) 979-2067

The provider's authorized official is Susan Vega .
The authorized official title is Office Contact and has the following contact phone number (850) 889-0711.

The enumeration date for this NPI number is 7/21/2016 and was last updated on 7/25/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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