Organization
A VIVID AGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIVIANA SCOTT (OWNER)
(202) 425-4137
Entity
Organization
Contact information
Practice address
2716 29TH ST SE APT B196, WASHINGTON, DC 20020-3170
(202) 425-4137
Mailing address
2716 29TH ST SE APT B196, WASHINGTON, DC 20020-3170
(202) 425-4137
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/22/2017
Last updated
07/21/2022
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