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General NPI Number Information
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NPI Number | 1851083695
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Entity Type | Organization
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Legal Business Name | VYVO THERAPEUTICS
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Dates
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Enumeration Date | 05/22/2023
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 2817 W LOOP 250 N STE A
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City | MIDLAND
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State | TX
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Zip | 79705-3205
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Country | US
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Telephone | 432-218-8054
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Fax |
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Provider Business Mailing Address
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Address Line | 2817 W LOOP 250 N STE A
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City | MIDLAND
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State | TX
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Zip | 79705-3205
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Country | US
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Telephone | 432-218-8054
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | NEIL DOCTOR
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Credential | MD
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Telephone | 432-218-8054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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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 | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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