Provider Demographics
NPI:1134391717
Name:TAO CENTER FOR VITALITY LONGEVITY & OPTIMAL HEALTH LLC
Entity type:Organization
Organization Name:TAO CENTER FOR VITALITY LONGEVITY & OPTIMAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MYRIAH
Authorized Official - Middle Name:WENONA
Authorized Official - Last Name:HINCHEY
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:860-377-0709
Mailing Address - Street 1:PO BOX 666
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:CT
Mailing Address - Zip Code:06248-0666
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 PENDLETON DR LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:CT
Practice Address - Zip Code:06248-1525
Practice Address - Country:US
Practice Address - Phone:860-377-0709
Practice Address - Fax:860-228-4475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000339172P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172P00000XOther Service ProvidersNaprapathGroup - Single Specialty