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General NPI Number Information
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NPI Number | 1164164646
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Entity Type | Organization
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Legal Business Name | LIFESTYLE FOUNDATIONS INC
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Dates
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Enumeration Date | 04/13/2022
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Last Update Date | 04/13/2022
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Provider Practice Location Address
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Address Line | 155 PRINTERS PKWY STE 110
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City | COLORADO SPRINGS
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State | CO
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Zip | 80910-6101
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Country | US
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Telephone | 719-574-5500
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Fax | 719-471-9053
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Provider Business Mailing Address
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Address Line | 155 PRINTERS PKWY STE 110
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City | COLORADO SPRINGS
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State | CO
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Zip | 80910-6101
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Country | US
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Telephone | 719-574-5500
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Fax | 719-471-9053
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MRS. ERICA CLAUDINE WILKERSON
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Credential |
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Telephone | 719-574-5500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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