Healthcare Provider Details

I. General information

NPI: 1982515409
Provider Name (Legal Business Name): VITALITY THERAPY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 DORNE DR
MANCHESTER MO
63021-6866
US

IV. Provider business mailing address

1006 DORNE DR
MANCHESTER MO
63021-6866
US

V. Phone/Fax

Practice location:
  • Phone: 314-322-3495
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LYNDSEY PATTERSON
Title or Position: OWNER
Credential:
Phone: 314-322-3495