| NPI | 1790151157 |
|---|---|
| Doing Business As | VITAL LIVING WELLSPA |
| Entity Type | Organization |
| Authorized Contact | JANET CARROLL Owner 260-436-8807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WM1400X Registered Nurse, Nurse Massage Therapist (NMT) (Licence: IN 28057959A) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: IN MT20901877) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-08-19 |