Provider Demographics
NPI:1649623521
Name:CORVIA ENTERPRISES, LLC
Entity type:Organization
Organization Name:CORVIA ENTERPRISES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:VANESSA
Authorized Official - Last Name:CORAM VIALET
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:340-513-3900
Mailing Address - Street 1:PO BOX 8821
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00801-1821
Mailing Address - Country:US
Mailing Address - Phone:340-513-3900
Mailing Address - Fax:800-854-4131
Practice Address - Street 1:9003 HAVENSIGHT MALL
Practice Address - Street 2:SUITE 317-318
Practice Address - City:ST. THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802
Practice Address - Country:US
Practice Address - Phone:340-513-3900
Practice Address - Fax:800-854-4131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT099-0000104175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty