# VITAL ENERGY OCC THERAPY & WELLNESS CTR LLC

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

## Provider details

- **NPI number:** 1700839610
- **Authorized official:** MRS. HIMA N DALAL OCCUPATIONAL THERAPI (OWNER)
- **Authorized official phone:** (803) 951-3200

## Contact information

- **Practice address:** 1812 AUGUSTA HWY, STE L, LEXINGTON, SC 29072
- **Practice address phone:** (803) 359-1551
- **Practice address fax:** (803) 233-9201
- **Mailing address:** 121 CLEARVIEW DR, COLUMBIA, SC 29212
- **Mailing address phone:** (803) 951-3200
- **Mailing address fax:** (803) 951-0990

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0100X | Occupational Medicine Clinic/Center | 2626 | SC | Yes |

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 04/20/2008