Individual
ELISABETH VITALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
34950 BROOTEN RD, PACIFIC CITY, OR 97135-8034
(919) 667-4676
Mailing address
PO BOX 333, AMITY, OR 97101-0333
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC178684
OR
Other
Enumeration date
08/07/2016
Last updated
12/19/2019
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