Provider Demographics
NPI:1477859296
Name:THE GOOD LIFE OF PALM BEACH
Entity Type:Organization
Organization Name:THE GOOD LIFE OF PALM BEACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUTHANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZENTNER
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:561-640-9090
Mailing Address - Street 1:44 COCOANUT ROW
Mailing Address - Street 2:SUITE # B22
Mailing Address - City:PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33480-4069
Mailing Address - Country:US
Mailing Address - Phone:561-640-9090
Mailing Address - Fax:561-640-9149
Practice Address - Street 1:931 VILLAGE BLVD
Practice Address - Street 2:SUITE 903
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-1803
Practice Address - Country:US
Practice Address - Phone:561-640-9090
Practice Address - Fax:561-640-9149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-27
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2063171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty