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Active Life, Llc
Prosthetic/Orthotic Supplier in Palmdale, California
NPI 1366953168

Active Life, Llc is a Prosthetic/Orthotic Supplier based in Glendale, CA. Active Life, Llc practices in Palmdale, CA. The NPI Number for Active Life, Llc is 1366953168 and holds a License No. (California).

The current practice location address for Active Life, Llc is 190 Sierra Ct Ste A4, Palmdale, CA and can be reached out via phone at 818-495-4610 and via fax at 818-484-2812.

Location: 190 Sierra Ct Ste A4, Palmdale, CA, 91206-4741
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1366953168
Provider Name
Active Life, Llc
Credential
Provider Entity Type
Organization
Address
190 Sierra Ct Ste A4, Palmdale, CA, 91206-4741
Phone Number
818-495-4610
Fax Number
818-484-2812
Provider Enumeration Date
10/19/2017
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
190 Sierra Ct Ste A4
City
Palmdale
State
California
Zip
93550-7608
Phone Number
818-495-4610
Fax Number
818-484-2812
person
Provider Business Mailing Address Details
Address
190 Sierra Ct Ste A4
City
Palmdale
State
California
Zip
93550-7608
Phone Number
818-495-4610
Fax Number
818-484-2812
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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