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General NPI Number Information
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NPI Number | 1215369756
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Entity Type | Organization
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Legal Business Name | LA VIE ACUPUNCTURE CLINIC, INC
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Dates
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Enumeration Date | 08/07/2013
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Last Update Date | 08/07/2013
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Provider Practice Location Address
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Address Line | 2660 E MAIN ST STE 202
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City | VENTURA
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State | CA
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Zip | 93003-2774
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Country | US
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Telephone | 805-798-4018
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Fax |
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Provider Business Mailing Address
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Address Line | 215 E SUMMER ST APT 3
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City | OJAI
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State | CA
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Zip | 93023-2755
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Country | US
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Telephone | 805-798-4018
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Fax | 805-640-1866
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALEXANDRE HILLAIRET
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Credential |
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Telephone | 805-798-4018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC11849
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License Number State | CA
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