Provider Demographics
NPI:1689301749
Name:EVERYDAY VITALITY
Entity Type:Organization
Organization Name:EVERYDAY VITALITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUES
Authorized Official - Middle Name:R
Authorized Official - Last Name:DEPARDIEU
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:203-656-2000
Mailing Address - Street 1:6 THORNDAL CIR
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-5415
Mailing Address - Country:US
Mailing Address - Phone:203-656-2000
Mailing Address - Fax:
Practice Address - Street 1:6 THORNDAL CIR
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-5415
Practice Address - Country:US
Practice Address - Phone:203-656-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty