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General NPI Number Information
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NPI Number | 1225937113
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Entity Type | Organization
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Legal Business Name | VITALITY COLLECTIVE, LLC
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Dates
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Enumeration Date | 11/05/2026
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Last Update Date | 11/05/2026
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Provider Practice Location Address
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Address Line | 4101 MORRIS ST NE STE B
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-3605
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Country | US
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Telephone | 505-441-2344
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Fax | 866-835-8369
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Provider Business Mailing Address
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Address Line | 750 SHERRI CT
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City | BOSQUE FARMS
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State | NM
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Zip | 87068-9770
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Country | US
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Telephone | 505-615-7972
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MONICA REMPEN
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Credential | DOM
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Telephone | 505-441-2344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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