| The Life Source Llc | |
|
3228 University Ave Ste 103 Columbus GA 31907-7201 | |
| (762) 207-8218 | |
| (706) 400-6478 |
| Full Name | The Life Source Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3228 University Ave Ste 103, Columbus, Georgia |
| Authorized Official Name and Position | Lateasha Skinner (CEO) |
| Authorized Official Contact | 7622078218 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Life Source Llc 3228 University Ave Ste 103 Columbus GA 31907-7201 Ph: (762) 207-8218 | The Life Source Llc 3228 University Ave Ste 103 Columbus GA 31907-7201 Ph: (762) 207-8218 |
| NPI Number | 1477195154 |
|---|---|
| Provider Enumeration Date | 10/14/2019 |
| Last Update Date | 10/14/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477195154 | NPI | - | NPPES |
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