Vital Balance Acupuncture and Herbal Medicine LLC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

1763 Issued in CO

Legal business name

VITAL BALANCE ACUPUNCTURE AND HERBAL MEDICINE LLC

Doing business as

Dr. Mark VanOtterloo DAOM

Practice address

4288 Youngfield St
Wheat Ridge, CO 80033-2436

Phone

(720) 295-9323

Fax

(720) 295-9323

NPI assigned

Feb 13, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mark Ian Vanotterloo, DAOM

Title

Owner

Phone

(720) 295-9323

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Mark VanOtterloo DAOM Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1360713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698192000000",
    "number": "1871832782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4288 YOUNGFIELD ST",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800332436",
            "telephone_number": "720-295-9323",
            "fax_number": "720-295-9323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4288 YOUNGFIELD ST",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800332436",
            "telephone_number": "720-295-9323",
            "fax_number": "720-295-9323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL BALANCE ACUPUNCTURE AND HERBAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-13",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A",
        "authorized_official_last_name": "VANOTTERLOO",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "IAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-295-9323",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DAOM"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "CO",
            "license": "1763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1588937759",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Mark VanOtterloo DAOM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lawrence Rodney Vigil
• Selena Vigue
• Jennifer Ann Vincent, COTA
• Virtual Assessments, LLC
• Daniel Visel, LPC
• Jessica G Viton, DNP
• Nikolai Voitsekhovitch, PHARMD
• Stacy Shadburne Volk, PHARM. D.
• Mari Sara Volkmar, PA
• Lynn Marie Vollero

• Acupuncturist in Wheat Ridge, CO
• Providers in Wheat Ridge, CO by specialty
• Acupuncturist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.