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Active Life, Llc
Prosthetic/Orthotic Supplier in Rancho Mirage, California
NPI 1083284590

Active Life, Llc is a Prosthetic/Orthotic Supplier based in Glendale, CA. Active Life, Llc practices in Rancho Mirage, CA. The NPI Number for Active Life, Llc is 1083284590 and holds a License No. (California).

The current practice location address for Active Life, Llc is 72780 Country Club Dr Ste 300, Rancho Mirage, CA and can be reached out via phone at 909-748-0168 and via fax at 909-748-5881.

Location: 72780 Country Club Dr Ste 300, Rancho Mirage, CA, 91206-4741
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1083284590
Provider Name
Active Life, Llc
Credential
Provider Entity Type
Organization
Address
72780 Country Club Dr Ste 300, Rancho Mirage, CA, 91206-4741
Phone Number
909-748-0168
Fax Number
909-748-5881
Provider Enumeration Date
06/28/2021
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
72780 Country Club Dr Ste 300
City
Rancho Mirage
State
California
Zip
92270-4150
Phone Number
909-748-0168
Fax Number
909-748-5881
person
Provider Business Mailing Address Details
Address
72780 Country Club Dr Ste 300
City
Rancho Mirage
State
California
Zip
92270-4150
Phone Number
909-748-0168
Fax Number
909-748-5881
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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