| NPI | 1467249219 |
|---|---|
| Doing Business As | AGELESS DYNAMICS LLC |
| Entity Type | Organization |
| Authorized Contact | LORI KHRISTINE AXFORD Owner / Practitioner 425-971-0990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care |
| Enumeration Date | 2025-04-24 |
| Last Update Date | 2025-04-24 |