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NPI Code Detail

MEDICARE: VITALITY WELLNESS PA

MEDICARE: VITALITY WELLNESS PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician
2261QI0500XInfusion Therapy Clinic/Center
3261QP2000XPhysical Therapy Clinic/Center
4261QP3300XPain Clinic/Center
5261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1457972150
Entity Type Code : Organization
Provider Name (Legal Business Name) : VITALITY WELLNESS PA
Provider Business Mailing Address
First Line : 7650 CURRELL BLVD STE 330
Second Line :
City : WOODBURY
State : MN
Zip : 55125-8209
Country : US
Telephone Number : 651-738-7800
Fax Number :
Provider Business Practice Location Address
First Line : 7650 CURRELL BLVD STE 330
Second Line :
City : WOODBURY
State : MN
Zip : 55125-8209
Country : US
Telephone Number : 651-738-7800
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. DANIEL SCHILLING
Credential : DC
Telephone Number : 651-738-7800
Provider Enumeration Date : 05/04/2020
Last Update Date : 05/24/2020

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Directions to “VITALITY WELLNESS PA ” Practice Location

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