# VITALITY MEDICAL DISPENSARY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275077802
- **Authorized official:** DANIEL HANDFORD (DIRECTOR)
- **Authorized official phone:** (803) 218-9886

## Contact information

- **Practice address:** 103 SUM MOR DR, WEST COLUMBIA, SC 29169-4828
- **Practice address phone:** (803) 244-9212
- **Mailing address:** PO BOX 1320, LEXINGTON, SC 29071-1320

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/16/2016
- **Last updated:** 12/16/2016