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General NPI Number Information
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NPI Number | 1366254195
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Entity Type | Organization
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Legal Business Name | TOTAL VITALITY LLC
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 8955 RIDGELINE BLVD STE 800
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80129-2365
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Country | US
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Telephone | 720-894-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 8955 RIDGELINE BLVD STE 800
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80129-2365
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JASON VARTANIAN
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Credential |
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Telephone | 720-894-1300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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