Organization
LIFEPATH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERT J BELLG (PRESIDENT)
(920) 996-0887
Entity
Organization
Contact information
Practice address
1620 S LAWE ST, APPLETON, WI 54915-2400
(920) 996-0887
Mailing address
1620 S LAWE ST, APPLETON, WI 54915-2400
(920) 996-0887
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2382-57
WI
Other
Enumeration date
04/19/2010
Last updated
04/19/2010
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