Organization
LIFESTYLE COACHES LLC
Active
Other names
LSC Aerobic Fitness Boutique, LSC FITNESS STUDIO, NUHB Wellness Center Boutique
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARITA HERRON (CHIEF EXECUTIVE OFFICER)
(248) 688-5806
Entity
Organization
Contact information
Practice address
15565 NORTHLAND DR W STE 101W, SOUTHFIELD, MI 48075-5300
(248) 905-3111
(248) 995-3774
Mailing address
22519 TELEGRAPH RD, SOUTHFIELD, MI 48033-4106
(248) 688-5806
(248) 905-3447
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
MI
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/18/2017
Last updated
05/18/2022
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