Organization
LIVE 2 B HEALTHY SENIOR FITNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORY CZEPA (PRESIDENT/CEO)
(612) 702-2679
Entity
Organization
Contact information
Practice address
6110 BLUE CIRCLE DR, SUITE 230, MINNETONKA, MN 55343-9128
(612) 702-2679
Mailing address
6110 BLUE CIRCLE DR, SUITE 230, MINNETONKA, MN 55343-9128
(612) 702-2679
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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