# AGING VITALITY LLC

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

## Provider details

- **NPI number:** 1639950249
- **Authorized official:** MELISSA WESTERGARD PTA (PHYSICAL THERAPIST ASSISTANT)
- **Authorized official phone:** (720) 305-8214

## Contact information

- **Practice address:** 472 MEETING ST STE C-140, CHARLESTON, SC 29403-4899
- **Practice address phone:** (720) 305-8214
- **Mailing address:** 472 MEETING ST STE C-140, CHARLESTON, SC 29403-4899
- **Mailing address phone:** (720) 305-8214

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/10/2023
- **Last updated:** 08/26/2024