Provider Demographics
NPI:1154986735
Name:INFINITE VITALITY LLC
Entity type:Organization
Organization Name:INFINITE VITALITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMRITPAL
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:ATTI
Authorized Official - Suffix:
Authorized Official - Credentials:CHIROPRACTIC
Authorized Official - Phone:503-252-5911
Mailing Address - Street 1:13150 NE HALSEY ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-2350
Mailing Address - Country:US
Mailing Address - Phone:503-252-5911
Mailing Address - Fax:
Practice Address - Street 1:13150 NE HALSEY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-2350
Practice Address - Country:US
Practice Address - Phone:503-252-5911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service