VITALITY FUNCTIONAL MEDICINE LLC
Organization (NPI-2)
Active
Nurse Practitioner, Family
Provider Information
- NPI Number
1821517954- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 155 SW CENTURY DR STE 111, BEND, OR, 977021657
- Phone
- (458) 206-3331
- Fax
- (620) 506-4777
Specialties & Taxonomies
Nurse Practitioner, Family
Primary License: OR #201706673NP