Organization
LIFE FUSION LLC
Active
Organization
LIFE FUSION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TORY HINKLE MD (CO-FOUNDER)
(801) 698-3710
Entity
Organization
Contact information
Practice address
440 MEDICAL DR STE 3, BOUNTIFUL, UT 84010-5174
(801) 698-3710
(801) 823-0225
Mailing address
242 LEWIS PARK CIR, BOUNTIFUL, UT 84010-5742
(801) 698-3710
(801) 823-0225
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
03/24/2022
Last updated
03/24/2022
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