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General NPI Number Information
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NPI Number | 1407778871
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Entity Type | Organization
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Legal Business Name | VITALITY MANSFIELD, LLC
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Dates
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Enumeration Date | 07/28/2026
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Last Update Date | 07/28/2026
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Provider Practice Location Address
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Address Line | 625 LEXINGTON AVE STE 6
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City | MANSFIELD
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State | OH
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Zip | 44907-1579
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Country | US
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Telephone | 419-989-4342
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Fax | 419-522-1113
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Provider Business Mailing Address
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Address Line | 625 LEXINGTON AVE STE 6
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City | MANSFIELD
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State | OH
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Zip | 44907-1579
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Country | US
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Telephone | 419-989-4342
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Fax | 419-522-1113
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MELISSA MCRAE
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Credential | DO
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Telephone | 419-989-4342
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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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