Organization
THE LIFESTYLE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDERSON CARLOS GONCALVES L.AC., D.A.C.M (ACUPUNCTURE PHYSCIAN - OWNER)
(352) 693-2681
Entity
Organization
Contact information
Practice address
10935 SE 177TH PL STE 201, SUMMERFIELD, FL 34491-8971
(352) 693-2681
Mailing address
10935 SE 177TH PL STE 201, SUMMERFIELD, FL 34491-8971
(352) 693-2681
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Enumeration date
09/07/2023
Last updated
09/07/2023
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