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Active Life, Llc
Prosthetic/Orthotic Supplier in Lakewood, California
NPI 1073162244

Active Life, Llc is a Prosthetic/Orthotic Supplier based in Glendale, CA. Active Life, Llc practices in Lakewood, CA. The NPI Number for Active Life, Llc is 1073162244 and holds a License No. (California).

The current practice location address for Active Life, Llc is 3300 E South St Ste 305, Lakewood, CA and can be reached out via phone at 562-304-9866 and via fax at 562-304-9845.

Location: 3300 E South St Ste 305, Lakewood, CA, 91206-4741
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1073162244
Provider Name
Active Life, Llc
Credential
Provider Entity Type
Organization
Address
3300 E South St Ste 305, Lakewood, CA, 91206-4741
Phone Number
562-304-9866
Fax Number
562-304-9845
Provider Enumeration Date
09/10/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
XC0009601 05 CA
institution
Provider Business Practice Location Address Details
Address
3300 E South St Ste 305
City
Lakewood
State
California
Zip
90805-4595
Phone Number
562-304-9866
Fax Number
562-304-9845
person
Provider Business Mailing Address Details
Address
3300 E South St Ste 305
City
Lakewood
State
California
Zip
90805-4595
Phone Number
562-304-9866
Fax Number
562-304-9845
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
()
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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