Organization
ACTIVE INTEGRATED MEDICINE LLC
Active
Organization
ACTIVE INTEGRATED MEDICINE LLC
Active
Other names
Active Integrated Medicine, Proactive Medicine LLC
Organization subpart
No
Provider details
NPI number
Authorized official
LEIF ALLEN STEPHENS DC (OWNER)
(970) 458-5216
Entity
Organization
Contact information
Practice address
220 E BEAVER AVE, FORT MORGAN, CO 80701-3103
(970) 441-1117
Mailing address
220 E BEAVER AVE, FORT MORGAN, CO 80701-3103
(970) 441-1117
Taxonomy
Speciality
Code
Description
License number
State
202D00000X
Integrative Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679771414
NPI
CO
05
—
1679771414
—
CO
Enumeration date
06/12/2018
Last updated
03/30/2026
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