Provider Demographics
NPI:1730435116
Name:AGELESS MEN'S HEALTH HOLDINGS, INC
Entity type:Organization
Organization Name:AGELESS MEN'S HEALTH HOLDINGS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-818-0446
Mailing Address - Street 1:4970 W HIGHWAY 290
Mailing Address - Street 2:SUITE 470
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-6748
Mailing Address - Country:US
Mailing Address - Phone:512-250-5300
Mailing Address - Fax:512-250-5304
Practice Address - Street 1:4970 W HIGHWAY 290
Practice Address - Street 2:SUITE 470
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-6748
Practice Address - Country:US
Practice Address - Phone:512-250-5300
Practice Address - Fax:512-250-5304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-03
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty