Organization
A BALANCED LIFE WELLNESS CLINIC AND APOTHECARY, LLC
Active
Organization
A BALANCED LIFE WELLNESS CLINIC AND APOTHECARY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETSY COSTILO (PRESIDENT)
(301) 602-1518
Entity
Organization
Contact information
Practice address
1818 LIBRARY ST, STE 500, RESTON, VA 20190-6242
(301) 602-1518
Mailing address
1818 LIBRARY ST, STE 500, RESTON, VA 20190-6242
(301) 602-1518
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Enumeration date
09/04/2014
Last updated
09/04/2014
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