| Ageless Dynamics , LLC | |
|
9200 Nw 39th Ave Ste 130-3170 Gainesville FL 32606-7331 | |
| (352) 201-3701 | |
| Not Available |
| Full Name | Ageless Dynamics , LLC |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 9200 Nw 39th Ave Ste 130-3170, Gainesville, Florida |
| Authorized Official Name and Position | Lori Khristine Axford (OWNER) |
| Authorized Official Contact | 4259710990 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ageless Dynamics , LLC 9200 Nw 39th Ave Ste 130-3170 Gainesville FL 32606-7331 Ph: (352) 201-3701 | Ageless Dynamics , LLC 9200 Nw 39th Ave Ste 130-3170 Gainesville FL 32606-7331 Ph: (352) 201-3701 |
| NPI Number | 1922777390 |
|---|---|
| Provider Enumeration Date | 09/09/2021 |
| Last Update Date | 10/06/2021 |
| Certification Date | 10/06/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922777390 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
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