Provider Demographics
NPI:1982270690
Name:LATITUDE ACUPUNCTURE & WELLNESS, LLC
Entity Type:Organization
Organization Name:LATITUDE ACUPUNCTURE & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:L. AC.
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:KINTOP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-321-2109
Mailing Address - Street 1:41 IDX DR STE 221
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-7774
Mailing Address - Country:US
Mailing Address - Phone:802-321-2109
Mailing Address - Fax:
Practice Address - Street 1:41 IDX DR STE 221
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-7774
Practice Address - Country:US
Practice Address - Phone:802-321-2109
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty