| NPI | 1639590961 |
|---|---|
| Doing Business As | LIFETIME FAMILY WELLNESS |
| Entity Type | Organization |
| Authorized Contact | GERALD BURKELY LARSEN Owner 435-851-6223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: UT 7564602-1202) |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2015-08-06 |