Organization
VITALIZED PERFORMANCE GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GORICA MLADEN-ADDUCI (OWNER)
(917) 560-0249
Entity
Organization
Contact information
Practice address
212 NEW LONDON TPKE STE D, GLASTONBURY, CT 06033-4202
(860) 430-2342
(860) 430-2342
Mailing address
212 NEW LONDON TPKE STE D, GLASTONBURY, CT 06033-4202
(860) 430-2342
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427201540
—
CT
05
—
1609232081
—
CT
05
—
1992858583
—
CT
Enumeration date
08/10/2022
Last updated
08/10/2022
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