Organization
PURA VITALITY WELLNESS CENTER, PC
Active
Other names
Magnolia Aesthetics, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DARYA P. ZAKIROV NP (NP)
(508) 455-1018
Entity
Organization
Contact information
Practice address
550 N MAIN ST STE 5, ATTLEBORO, MA 02703-1735
(508) 837-5623
(508) 455-1054
Mailing address
550 N MAIN ST STE 5, ATTLEBORO, MA 02703-1735
(508) 455-1018
(508) 455-1054
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN2298940
MA LICENSE
MA
01
—
RN2301955
MA LICENSE
MA
Enumeration date
01/09/2023
Last updated
10/29/2025
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