Organization
THE LONGEVITY LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMAD JARBOU MD (CO-OWNER)
(573) 639-0292
Entity
Organization
Contact information
Practice address
100 S KEENE ST, COLUMBIA, MO 65201-6603
(573) 968-6822
Mailing address
100 S KEENE ST, COLUMBIA, MO 65201-6603
(573) 968-6822
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
04/25/2025
Last updated
04/25/2025
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