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General NPI Number Information
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NPI Number | 1972021301
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Entity Type | Organization
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Legal Business Name | VITAL LIVING HEALTHCARE SERVICES, LLC
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Dates
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Enumeration Date | 09/06/2017
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 6115 PEACHTREE DUNWOODY RD STE 200
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City | ATLANTA
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State | GA
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Zip | 30328-5684
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Country | US
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Telephone | 404-843-3636
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Fax | 404-891-7164
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Provider Business Mailing Address
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Address Line | 6115 PEACHTREE DUNWOODY RD STE 200
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City | ATLANTA
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State | GA
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Zip | 30328-5684
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Country | US
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Telephone | 404-843-3636
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Fax | 404-891-7164
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL E. COX
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Credential | MD
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Telephone | 404-843-3636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 049762
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License Number State | GA
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