Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rehabilitation |
163WR0400X | |||
Rehabilitation Practitioner |
225400000X |
| NPI # | 1043728355 |
| LBN Legal business name | LIVE STRONGER BUS |
| Authorized official | ANNICE SIMMONS - (PARTNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 01/21/2018 |
| Last updated | 01/21/2018 - About 8 years ago |
| Identifiers | n/a |
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