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Organization
LIFE EXTENSION AND WELLNESS CENTER INC
Active
Organization
LIFE EXTENSION AND WELLNESS CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA B BURKE (MCC)
(954) 921-9555
Entity
Organization
Contact information
Practice address
1418 S FEDERAL HWY, DANIA BEACH, FL 33004-4349
(954) 921-9555
(954) 921-9556
Mailing address
1418 S FEDERAL HWY, DANIA BEACH, FL 33004-4349
(954) 921-9555
(954) 921-9556
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
12/08/2011
Last updated
11/21/2016
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