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General NPI Number Information
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NPI Number | 1437749660
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Entity Type | Organization
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Legal Business Name | PRECISION INTEGRATIVE MEDICINE, LLC
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Dates
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Enumeration Date | 01/21/2021
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Last Update Date | 02/23/2021
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Provider Practice Location Address
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Address Line | 835 7TH ST STE 1
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City | CLERMONT
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State | FL
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Zip | 34711-2190
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Country | US
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Telephone | 352-901-4513
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Fax |
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Provider Business Mailing Address
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Address Line | 877 W MINNEOLA AVE # 121262
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City | CLERMONT
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State | FL
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Zip | 34712-1262
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Country | US
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Telephone | 352-901-4513
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURE PHYSICIAN
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Name | DR. DUSTIN VAUGHAN
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Credential | PMD, DIPL. OM, AP
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Telephone | 352-901-4513
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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 |
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License Number State |
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