Healthcare Provider Details

I. General information

NPI: 1578337614
Provider Name (Legal Business Name): VITAL TOUCH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2023
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 S STATE ST STE 100
OREM UT
84058-6321
US

IV. Provider business mailing address

PO BOX 970842
OREM UT
84097-0842
US

V. Phone/Fax

Practice location:
  • Phone: 801-318-3131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: KEVIN WISCOMBE
Title or Position: MANAGER
Credential:
Phone: 801-318-3131