# VITAL HEALTHCARE AZ LLC

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

## Provider details

- **NPI number:** 1346978194
- **Authorized official:** SEAN TESSMAN (OWNER)
- **Authorized official phone:** (928) 968-3558

## Contact information

- **Practice address:** 3075 N WINDSONG DR STE A, PRESCOTT VALLEY, AZ 86314-1208
- **Practice address phone:** (928) 968-3558
- **Mailing address:** 13702 E QUAIL CT, DEWEY, AZ 86327-4494

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/10/2022
- **Last updated:** 08/10/2022