Organization
LIFECRAFT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY JO PUTNAM CERTIFIED INSTRUCTOR (MANAGER)
(269) 612-7222
Entity
Organization
Contact information
Practice address
19246 THREE OAKS RD, THREE OAKS, MI 49128-9511
(269) 612-7222
Mailing address
19246 THREE OAKS RD, THREE OAKS, MI 49128-9511
(269) 612-7222
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
—
—
224Y00000X
Clinical Exercise Physiologist
—
—
2255A2300X
Athletic Trainer
Primary
—
—
225800000X
Recreation Therapist
—
—
226000000X
Recreational Therapist Assistant
—
—
Other
Enumeration date
09/27/2020
Last updated
09/27/2020
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