Organization
VITAL YOGA THERAPEUTICS, LLC
Active
Other names
VitalTherapy, Vital Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LIANA RASCHKE VALLA OTR/L, IYTT, OMC (OWNER)
(904) 874-5152
Entity
Organization
Contact information
Practice address
2225 A1A S STE B1, SAINT AUGUSTINE, FL 32080-7906
(904) 874-5152
Mailing address
1199 SAN JOSE FOREST DR, SAINT AUGUSTINE, FL 32080-5412
(904) 874-5152
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
—
—
Other
Enumeration date
04/10/2020
Last updated
04/10/2020
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