NPI 1366953168

Active Life, LLC

Organisation Prosthetic/Orthotic Supplier Palmdale, CA

Practice location

Address: 190 Sierra CT STE A4, Palmdale, CA 93550-7608
Phone: (818) 495-4610
Fax: (818) 484-2812
Mailing address: 1577 E Chevy Chase Dr STE 210, Glendale, CA 91206-4741

Authorised official

Name: Spencer Arden Doty
Title: President
Phone: (858) 616-7724

Registered specialties

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X

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Registry record

NPI: 1366953168
Entity type: Organization
NPI issued: 19 Oct 2017
Record last updated: 14 Jan 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.