Healthcare Provider Details

I. General information

NPI: 1245096908
Provider Name (Legal Business Name): VORI HEALTH MEDICAL GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2024
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 S BENSON RD
FAIRFIELD CT
06824-6941
US

IV. Provider business mailing address

100 POWELL PL # 1441
NASHVILLE TN
37204-3622
US

V. Phone/Fax

Practice location:
  • Phone: 248-761-4683
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: RYAN A, GRANT
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 248-761-4683