Provider Demographics
NPI:1720340623
Name:LIFETECH CONSULTING
Entity Type:Organization
Organization Name:LIFETECH CONSULTING
Other - Org Name:REX ALAN SPENDLOVE, MS, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:REX
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SPENDLOVE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PC
Authorized Official - Phone:435-213-3687
Mailing Address - Street 1:1635 N 200 E
Mailing Address - Street 2:
Mailing Address - City:NORTH LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-1913
Mailing Address - Country:US
Mailing Address - Phone:435-213-3687
Mailing Address - Fax:435-753-7654
Practice Address - Street 1:1635 N 200 E
Practice Address - Street 2:
Practice Address - City:NORTH LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-1913
Practice Address - Country:US
Practice Address - Phone:435-213-3687
Practice Address - Fax:435-753-7654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7788192-6004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty