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General NPI Number Information
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NPI Number | 1184283962
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Entity Type | Organization
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Legal Business Name | VITALITY HEALTH LLC
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Dates
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Enumeration Date | 06/06/2019
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Last Update Date | 06/06/2019
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Provider Practice Location Address
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Address Line | 2211 CROCKER RD STE 170
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City | WESTLAKE
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State | OH
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Zip | 44145-7603
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Country | US
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Telephone | 440-250-0822
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Fax |
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Provider Business Mailing Address
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Address Line | 2211 CROCKER RD STE 170
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City | WESTLAKE
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State | OH
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Zip | 44145-7603
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Country | US
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Telephone | 440-250-0822
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALANA MERCER
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Credential | PA
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Telephone | 440-250-0822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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