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General NPI Number Information
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NPI Number | 1770452534
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Entity Type | Organization
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Legal Business Name | LIFTING LGNDZ
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Dates
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Enumeration Date | 10/31/2025
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 10547 MONTGOMERY RD
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City | MONTGOMERY
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State | OH
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Zip | 45242-4418
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Country | US
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Telephone | 513-913-3316
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Fax |
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Provider Business Mailing Address
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Address Line | 339 WALNUT LN
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City | MASON
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State | OH
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Zip | 45040-2012
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | HUMAN MOVEMENT SPECIALIST
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Name | MR. DARYL RASHAUN SPENCER
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Credential |
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Telephone | 513-913-3316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Y00000X
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Taxonomy Name | Clinical Exercise Physiologist
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License Number |
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License Number State |
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