Organization · NPI-2

Elite Medical And Vitality LLC

Family Medicine · Sheridan, WY

NPI number1164214821
StatusActive
Last updated in NPPESMay 20, 2025

Details

NPI
1164214821
Entity type
Organization (NPI-2)
Legal business name
Elite Medical And Vitality LLC
Organization subpart
No
Enumeration date
May 20, 2025
Certification date
May 20, 2025
Last updated
May 20, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Practice location

1309 Coffeen Ave Ste 1200
Sheridan, WY 82801-5777

Phone 559-331-1649

Mailing address

1309 Coffeen Ave Ste 1200
Sheridan, WY 82801-5777

Authorized official

David Davis
Ceo
5593311649

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