Organization
AGELESS DYNAMICS LLC HYDRATE AND RENEW IV SOLUTIONS
Active
Organization
AGELESS DYNAMICS LLC HYDRATE AND RENEW IV SOLUTIONS
Active
Other names
Ageless Dynamics LLC
Organization subpart
No
Provider details
NPI number
Authorized official
LORI KHRISTINE AXFORD (OWNER / PRACTITIONER)
(425) 971-0990
Entity
Organization
Contact information
Practice address
19757 THE PLACE BLVD, ESTERO, FL 33928-6608
(425) 971-0990
Mailing address
19757 THE PLACE BLVD, ESTERO, FL 33928-6608
(425) 971-0990
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/24/2025
Last updated
04/24/2025
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