Healthcare Provider Details

I. General information

NPI: 1063390953
Provider Name (Legal Business Name): I FIX ATHLETES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20911 EARL ST STE 260
TORRANCE CA
90503-4360
US

IV. Provider business mailing address

35 PINEGROVE CT
ELMA NY
14059-9291
US

V. Phone/Fax

Practice location:
  • Phone: 716-367-7475
  • Fax:
Mailing address:
  • Phone: 716-807-5677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name: ALEXIS N LUCZAK
Title or Position: OWNER
Credential: ND
Phone: 716-807-5677