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General NPI Number Information
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NPI Number | 1306081955
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Entity Type | Organization
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Legal Business Name | VIGORWORKS, LLC
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Dates
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Enumeration Date | 12/11/2008
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Last Update Date | 07/21/2010
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Provider Practice Location Address
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Address Line | 313 SAGE LN
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City | PHILADELPHIA
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State | PA
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Zip | 19128-4556
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Country | US
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Telephone | 215-545-2000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 25817
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City | PHILADELPHIA
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State | PA
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Zip | 19128-5817
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Country | US
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Telephone | 215-545-2000
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MR. SAMUEL Y. BOTTS
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Credential |
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Telephone | 215-545-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DN003988
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License Number State | PA
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