Organization
D-LIFE FITNESS, LLC
Active
Parent organization
D-LIFE FITNESS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
D-LIFE FITNESS, LLC
Authorized official
SHAMAR ELAINE RICH-HALL (REGISTERED AGENT / BOOKKEEPER)
(754) 214-1177
Entity
Organization
Contact information
Practice address
711 VANDIVER DR STE J&K, COLUMBIA, MO 65202-1593
(573) 289-7334
Mailing address
711 VANDIVER DR STE J&K, COLUMBIA, MO 65202-1593
(573) 289-7334
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
11/12/2013
Last updated
11/12/2013
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