Vitality Therapy And Performance, LLC
Clinic/Center, Physical Therapy in Tulsa, OK. Organization (NPI-2).
NPI number1942829700
StatusActive
Last updated in NPPESJun 7, 2023
Details
- NPI
- 1942829700
- Entity type
- Organization (NPI-2)
- Legal business name
- Vitality Therapy And Performance, LLC
- Organization subpart
- No
- Enumeration date
- Apr 13, 2020
- Certification date
- Jun 7, 2023
- Last updated
- Jun 7, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2000X | Clinic/Center, Physical Therapy | – | – | Yes |
Practice location
8988 S Sheridan Rd Ste ATulsa, OK 74133-5035
Phone 918-265-4688
Mailing address
8988 S Sheridan Rd Ste ATulsa, OK 74133-5035
Phone 918-265-4688
Authorized official
Justin Cord Demoss
Managing Partner
9039187499
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