Provider Demographics
NPI:1932061280
Name:VITALITY MED SPA
Entity type:Organization
Organization Name:VITALITY MED SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:SADLER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:480-854-8000
Mailing Address - Street 1:1955 N VAL VISTA DR STE 101
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-3218
Mailing Address - Country:US
Mailing Address - Phone:480-854-8000
Mailing Address - Fax:480-854-8020
Practice Address - Street 1:1955 N VAL VISTA DR STE 101
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85213-3218
Practice Address - Country:US
Practice Address - Phone:480-854-8000
Practice Address - Fax:480-854-8020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-25
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty