Organization
VASAIO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKIE BENNETT (OWNER)
(616) 942-2966
Entity
Organization
Contact information
Practice address
1100 E PARIS AVE SE, GRAND RAPIDS, MI 49546-8367
(616) 942-2966
Mailing address
1100 E PARIS AVE SE, GRAND RAPIDS, MI 49546-8367
(616) 942-2966
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
5101012967
MI
225700000X
Massage Therapist
5101012967
MI
Other
Enumeration date
03/11/2008
Last updated
08/06/2012
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