| NPI | 1063106193 |
|---|---|
| Doing Business As | FUNCTION 4 LIFE |
| Entity Type | Organization |
| Authorized Contact | DAVID ANDREW GLAZER Owner 540-820-2988 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-06-02 |
| Last Update Date | 2023-06-22 |