| Lifetime Wellness, Inc. | |
|
1675 Upland Ave Boulder CO 80304-0830 | |
| (303) 589-6802 | |
| Not Available |
| Full Name | Lifetime Wellness, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1675 Upland Ave, Boulder, Colorado |
| Authorized Official Name and Position | Diane B Byington (PRESIDENT) |
| Authorized Official Contact | 3035896802 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifetime Wellness, Inc. Po Box 876 Niwot CO 80544-0876 Ph: (303) 589-0680 | Lifetime Wellness, Inc. 1675 Upland Ave Boulder CO 80304-0830 Ph: (303) 589-6802 |
| NPI Number | 1174714265 |
|---|---|
| Provider Enumeration Date | 08/05/2007 |
| Last Update Date | 08/05/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174714265 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 992045 (Colorado) | Primary |
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