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1083876734
LIFE ENHANCEMENT CENTER
PROVO, UT
NPI
1083876734
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Entity Type
Organization
Authorized Contact
RUSSELL C GAEDE
Executive Director
801-623-4770
Organization Subpart ?
No
Primary Taxonomy
251S00000X
(Licence: UT 6332186-0142)
Enumeration Date
2008-06-25
Last Update Date
2008-06-25
Business Address
LIFE ENHANCEMENT CENTER
1835 N 1120 W
PROVO, UT 84604-1180
Phone number: 801-623-4770
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Mailing Address
LIFE ENHANCEMENT CENTER
1835 N 1120 W
PROVO, UT 84604-1180
Phone number: 801-623-4770
Copy
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