# VITALITY ACUPUNCTURE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205337656
- **Authorized official:** HEATHER ANN BERGSTROM LAC (OWNER)
- **Authorized official phone:** (208) 629-4920

## Contact information

- **Practice address:** 1500 W BARRETT DR, MERIDIAN, ID 83642-3728
- **Practice address phone:** (208) 629-4920
- **Practice address fax:** (888) 361-5391
- **Mailing address:** 1500 W BARRETT DR, MERIDIAN, ID 83642-3728
- **Mailing address phone:** (208) 629-4920
- **Mailing address fax:** (888) 361-5391

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | ACU279 | — | Yes |

## Other

- **Enumeration date:** 02/21/2018
- **Last updated:** 02/21/2018