Healthcare Provider Details
I. General information
NPI: 1467369439
Provider Name (Legal Business Name): VITALITY WELLNESS GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
210 N MAIN ST UNIT 7
SHARON MA
02067-1276
US
IV. Provider business mailing address
210 N MAIN ST UNIT 7
SHARON MA
02067-1276
US
V. Phone/Fax
- Phone: 203-470-6363
- Fax:
- Phone: 203-470-6363
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LAURA
BLOOD
Title or Position: FOUNDER/CLINIC DIRECTOR
Credential: PT, DPT, GCS, CLT
Phone: 203-470-6363