# MEN'S VITALITY CENTER, PLLC

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

## Provider details

- **NPI number:** 1568782308
- **Authorized official:** NIKKI MIGLORE DC (OWNER/MBR)
- **Authorized official phone:** (480) 229-1986

## Contact information

- **Practice address:** 4653 S LAKESHORE DR, SUITE 2, TEMPE, AZ 85282-7161
- **Practice address phone:** (480) 456-8981
- **Mailing address:** 12878 N 119TH ST, SCOTTSDALE, AZ 85259-2736

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 364SA2200X | Adult Health Clinical Nurse Specialist | — | NULL | Yes |
| 364SA2200X | Adult Health Clinical Nurse Specialist | — | — | Yes |

## Other

- **Enumeration date:** 06/03/2010
- **Last updated:** 06/03/2010