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Active Life, Llc
Prosthetic/Orthotic Supplier in Northridge, California
NPI 1902852056

Active Life, Llc is a Prosthetic/Orthotic Supplier based in Glendale, CA. Active Life, Llc practices in Northridge, CA. The NPI Number for Active Life, Llc is 1902852056 and holds a License No. (California).

The current practice location address for Active Life, Llc is 18433 Roscoe Blvd Ste 108, Northridge, CA and can be reached out via phone at 818-835-9441 and via fax at 818-539-7962.

Location: 18433 Roscoe Blvd Ste 108, Northridge, CA, 91206-4741
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1902852056
Provider Name
Active Life, Llc
Credential
Provider Entity Type
Organization
Address
18433 Roscoe Blvd Ste 108, Northridge, CA, 91206-4741
Phone Number
818-835-9441
Fax Number
818-539-7962
Provider Enumeration Date
05/26/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
XC0009601 05 CA
institution
Provider Business Practice Location Address Details
Address
18433 Roscoe Blvd Ste 108
City
Northridge
State
California
Zip
91325-4131
Phone Number
818-835-9441
Fax Number
818-539-7962
person
Provider Business Mailing Address Details
Address
18433 Roscoe Blvd Ste 108
City
Northridge
State
California
Zip
91325-4131
Phone Number
818-835-9441
Fax Number
818-539-7962
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
(California)
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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