Lifevantage Home Health, LLC

NPI #1851797427 in Burleson, Texas

Provider Information

NPI Number: 1851797427
Entity Type: Organization
Organization Name: Lifevantage Home Health, LLC
Primary Specialty: Home Health
Enumeration Date: Nov 10, 2014
Last Updated: Nov 10, 2014

Practice Location

Address: 110 SW THOMAS ST
City: Burleson
State: Texas
ZIP Code: 76028-3818
Phone: (817) 541-4153

Authorized Official

Name: MR. GERSON PINOTE CONSERMAN
Title: OWNER
Phone: (817) 541-4153

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Home Health	251E00000X	Primary

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