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Organization
VITALITY AGELESS CENTER LLC
Active
Organization
VITALITY AGELESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA JONES (AO)
(215) 292-0275
Entity
Organization
Contact information
Practice address
5100 POPLAR AVE FL 27, MEMPHIS, TN 38137-2701
(770) 614-6266
Mailing address
1300 PEACHTREE INDUSTRIAL BLVD STE 1201, SUWANEE, GA 30024-4550
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/14/2025
Last updated
02/14/2025
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