NPI | 1518673433 |
---|---|
Former Legal Business Name | VIETRULIFE MEDICAL SPA |
Entity Type | Organization |
Authorized Contact | ANGEL RIVERA CFO 321-333-2573 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Enumeration Date | 2023-01-24 |
Last Update Date | 2023-08-24 |