Organization
VITALITY ACUPUNCTURE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER ANN BERGSTROM LAC (OWNER)
(208) 629-4920
Entity
Organization
Contact information
Practice address
1500 W BARRETT DR, MERIDIAN, ID 83642-3728
(208) 629-4920
(888) 361-5391
Mailing address
1500 W BARRETT DR, MERIDIAN, ID 83642-3728
(208) 629-4920
(888) 361-5391
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
ACU279
—
Other
Enumeration date
02/21/2018
Last updated
02/21/2018
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