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General NPI Number Information
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NPI Number | 1437295706
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Entity Type | Organization
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Legal Business Name | LIFE SUSTAINABILITY GROUP, INC.
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10601 LOMAS BLVD NE STE 103
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-5462
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Country | US
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Telephone | 505-298-5995
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Fax | 505-298-2940
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Provider Business Mailing Address
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Address Line | 10601 LOMAS BLVD NE STE 103
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-5462
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Country | US
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Telephone | 505-298-5995
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Fax | 505-298-2940
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. REX DRAMAN
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Credential | PHD
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Telephone | 512-659-4304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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