Healthcare Provider Details

I. General information

NPI: 1295699205
Provider Name (Legal Business Name): VITALIS HEALTH SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2025
Last Update Date: 12/13/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

162 BOSC CT
TELFORD PA
18969-2178
US

IV. Provider business mailing address

162 BOSC CT
TELFORD PA
18969-2178
US

V. Phone/Fax

Practice location:
  • Phone: 215-704-1356
  • Fax:
Mailing address:
  • Phone: 215-704-1356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BOBEN BABU
Title or Position: OWNER
Credential: PT, DPT
Phone: 215-704-1356