# EMBODIED VIRTUE

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

## Provider details

- **NPI number:** 1700434842
- **Authorized official:** JESSICA YOUNGS L.AC. (MEMBER/OWNER)
- **Authorized official phone:** (330) 618-8273

## Contact information

- **Practice address:** 307 CHURCH ST, SANDPOINT, ID 83864-1344
- **Practice address phone:** (208) 254-1188
- **Mailing address:** 307 CHURCH ST, SANDPOINT, ID 83864-1344
- **Mailing address phone:** (208) 254-1188

## Taxonomy

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

## Other

- **Enumeration date:** 09/02/2019
- **Last updated:** 09/02/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | ACU-370 | ACUPUNCTURE LICENSE | ID |
| 01 | — | ACU-371 | ACUPUNCTURE LICENSE | ID |