| NPI | 1376728659 |
|---|---|
| Former Legal Business Name | LIVE FOREVER YOUNG INC |
| Entity Type | Organization |
| Authorized Contact | VICTORIA T LE President 972-506-8776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: TX 10534) |
| Enumeration Date | 2008-01-04 |
| Last Update Date | 2009-05-20 |