Provider Demographics
NPI:1649865619
Name:VIM ACUPUNCTURE AND INTEGRATED WELLNESS CENTER, LLC
Entity type:Organization
Organization Name:VIM ACUPUNCTURE AND INTEGRATED WELLNESS CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:NETLING
Authorized Official - Suffix:
Authorized Official - Credentials:DOM, LAC
Authorized Official - Phone:772-333-8647
Mailing Address - Street 1:PO BOX 280
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32961-0280
Mailing Address - Country:US
Mailing Address - Phone:772-774-7775
Mailing Address - Fax:772-264-3181
Practice Address - Street 1:87 ROYAL PALM PT
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4253
Practice Address - Country:US
Practice Address - Phone:772-333-8647
Practice Address - Fax:772-264-3181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-02
Last Update Date:2022-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty