| NPI | 1376312991 |
|---|---|
| Doing Business As | LIFESTYLERX |
| Entity Type | Organization |
| Authorized Contact | JOHN ABRAHAM President 417-619-1329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2023-12-22 |
| Last Update Date | 2024-12-23 |