Provider Demographics
NPI:1477961373
Name:ZEN FOR LIFE WELLNESS LLC
Entity Type:Organization
Organization Name:ZEN FOR LIFE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELEONORA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:619-890-8297
Mailing Address - Street 1:322 BROAD ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MILFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18337-1345
Mailing Address - Country:US
Mailing Address - Phone:570-409-4880
Mailing Address - Fax:
Practice Address - Street 1:322 BROAD ST
Practice Address - Street 2:SUITE 2
Practice Address - City:MILFORD
Practice Address - State:PA
Practice Address - Zip Code:18337-1345
Practice Address - Country:US
Practice Address - Phone:570-409-4880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOM000138171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty