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General NPI Number Information
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NPI Number | 1821407545
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Entity Type | Organization
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Legal Business Name | INSIGHTS FOR LIFE LLC
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Dates
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Enumeration Date | 08/06/2014
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Last Update Date | 08/06/2014
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Provider Practice Location Address
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Address Line | 20325 N 51ST AVE 112
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City | GLENDALE
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State | AZ
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Zip | 85308-5674
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Country | US
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Telephone | 623-249-5888
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Fax |
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Provider Business Mailing Address
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Address Line | 20325 N 51ST AVE 112
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City | GLENDALE
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State | AZ
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Zip | 85308-5674
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Country | US
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Telephone | 623-249-5888
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MARTHA REED
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Credential |
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Telephone | 623-249-5888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number | L13636212
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License Number State | AZ
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