Provider Demographics
NPI:1558117044
Name:VITALITY HEALTH CARE PLLC
Entity type:Organization
Organization Name:VITALITY HEALTH CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORA
Authorized Official - Middle Name:
Authorized Official - Last Name:FINCH
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, FNP
Authorized Official - Phone:928-267-4760
Mailing Address - Street 1:4731 S WHITE MOUNTAIN RD STE 1
Mailing Address - Street 2:
Mailing Address - City:SHOW LOW
Mailing Address - State:AZ
Mailing Address - Zip Code:85901-8079
Mailing Address - Country:US
Mailing Address - Phone:928-267-4761
Mailing Address - Fax:928-304-7869
Practice Address - Street 1:4731 S WHITE MOUNTAIN RD STE 1
Practice Address - Street 2:
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-8079
Practice Address - Country:US
Practice Address - Phone:928-267-4761
Practice Address - Fax:928-304-7869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty