Provider Demographics
NPI:1689964199
Name:VREELAND ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:VREELAND ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURE PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MIMI
Authorized Official - Middle Name:
Authorized Official - Last Name:VREELAND
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:904-814-4323
Mailing Address - Street 1:PO BOX 840283
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-0283
Mailing Address - Country:US
Mailing Address - Phone:904-814-4323
Mailing Address - Fax:
Practice Address - Street 1:2180 A1A S
Practice Address - Street 2:SUITE 104
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-6591
Practice Address - Country:US
Practice Address - Phone:904-814-4323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-18
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty