MEDICARE: LIFESTYLE HEALTH THERAPIES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1346922655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFESTYLE HEALTH THERAPIES LLC

Provider Business Mailing Address
First Line	:	660 WEST CHERRY STREET
Second Line	:	SUITE 2
City	:	NORTH LIBERTY
State	:	IA
Zip	:	52317-9029
Country	:	US
Telephone Number	:	319-382-2743
Fax Number	:	319-359-4114

Provider Business Practice Location Address
First Line	:	660 WEST CHERRY STREET
Second Line	:	SUITE 2
City	:	NORTH LIBERTY
State	:	IA
Zip	:	52317-9029
Country	:	US
Telephone Number	:	319-382-2743
Fax Number	:	319-359-4114

Authorized Official
Title or Position	:	AUTHORIZED BUSINESS OWNER
Name	:	MRS. NATALIE FRIEDA JOHNSTON
Credential	:	M. PT
Telephone Number	:	319-382-2743

Provider Enumeration Date	:	08/04/2023
Last Update Date	:	01/10/2025

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