Organization
ACTIVELIFE THERAPY LLC
Active
Other names
Activelife Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD SAMANIEGO PT (OWNER)
(224) 499-4494
Entity
Organization
Contact information
Practice address
34121 U.S. 45 GRAYSLAKE, IL 60030, USA, STE 10, GAGES LAKE, IL 60030
(224) 499-4494
Mailing address
809 W GREENWOOD AVE APT 1D, WAUKEGAN, IL 60087-5049
(224) 499-4494
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
03/04/2025
Last updated
03/04/2025
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