Organization
VITAL VIBRANT HEALTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIANN MARIA DOMAGALSKI L.AC. (PRESIDENT)
(773) 366-2692
Entity
Organization
Contact information
Practice address
11608 DEAN ST, SUITE 203, HUNTLEY, IL 60142-9654
(773) 366-2692
Mailing address
11608 DEAN ST, SUITE 203, HUNTLEY, IL 60142-9654
(773) 366-2692
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
198.000837
IL
174400000X
Specialist
227.016464
IL
Other
Enumeration date
01/22/2014
Last updated
01/22/2014
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