D'vine Medical Spa, LLC

NPI #1598199135 in Middlebury, Connecticut

Provider Information

NPI Number: 1598199135
Entity Type: Organization
Organization Name: D'vine Medical Spa, LLC
Primary Specialty: Specialist
Enumeration Date: Aug 31, 2013
Last Updated: Oct 22, 2013

Practice Location

Address: 590 MIDDLEBURY RD
Address 2: SUITE 1
City: Middlebury
State: Connecticut
ZIP Code: 06762-2562
Phone: (203) 232-0208

Authorized Official

Name: MRS. NADINE MACARON
Title: PARTNER
Phone: (203) 232-0208

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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