| NPI | 1003227687 |
|---|---|
| Doing Business As | LIFESOURCE THERAPEUTICS |
| Entity Type | Organization |
| Authorized Contact | ROSEANNE VARNER Managing Partner 702-379-7592 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2014-05-19 |