Organization
D'VINE MEDICAL SPA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NADINE MACARON (PARTNER)
(203) 232-0208
Entity
Organization
Contact information
Practice address
590 MIDDLEBURY RD, SUITE 1, MIDDLEBURY, CT 06762-2562
(203) 232-0208
Mailing address
PO BOX 851, SUITE 1, MIDDLEBURY, CT 06762-0851
(203) 232-0208
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/31/2013
Last updated
10/22/2013
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