Lifestyle Medicine LLC

NPI #1245429216 in Las Vegas, New Mexico

Provider Information

NPI Number: 1245429216
Entity Type: Organization
Organization Name: Lifestyle Medicine LLC
Primary Specialty: Internal Medicine
Enumeration Date: Oct 16, 2007
Last Updated: Nov 26, 2007

Practice Location

Address: 1301 8TH ST
City: Las Vegas
State: New Mexico
ZIP Code: 87701-4221
Phone: (505) 425-2850

Authorized Official

Name: MRS. NANCY KANODE
Title: OFFICER
Phone: (505) 425-2850

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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