Organization
41LIFECHANGERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RODERICK GREEN (OWNER)
(941) 807-6374
Entity
Organization
Contact information
Practice address
1003 WINDTON OAK DR, RUSKIN, FL 33570-5330
(941) 807-6374
Mailing address
1003 WINDTON OAK DR, RUSKIN, FL 33570-5330
(941) 807-6374
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
10/17/2014
Last updated
10/17/2014
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