Organization
FUNCTIONAL LIFE CONSULTING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK HOWARD CABLE MS, OTR/L, CAPS (OWNER)
(847) 644-1280
Entity
Organization
Contact information
Practice address
3302 WEST LAKE WOODS, APARTMENT #126, ERIE, PA 16507-3677
(847) 644-1280
(847) 440-9000
Mailing address
3302 WEST LAKE WOODS, APARTMENT #126, ERIE, PA 16507-3677
(847) 644-1280
(847) 440-9000
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
261QX0100X
Occupational Medicine Clinic/Center
056010180
IL
310400000X
Assisted Living Facility
—
—
Other
Enumeration date
08/15/2015
Last updated
09/13/2021
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