| NPI | 1871591347 |
|---|---|
| Doing Business As | ACTIVE FOR LIFE |
| Entity Type | Organization |
| Authorized Contact | CARROLL DEAN SMITH Owner 503-693-9380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2010-11-02 |