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Organization
VITALITY AESTHETICS PLLC
Active
Organization
VITALITY AESTHETICS PLLC
Active
Parent organization
WOODLAND PARK FAMILY MEDICINE LLC
Other names
Vitality Aesthetics
Organization subpart
Yes
Provider details
NPI number
Legal business name
WOODLAND PARK FAMILY MEDICINE LLC
Authorized official
DR. MATTHEW C YOUNG MD (OWNER)
(719) 502-9779
Entity
Organization
Contact information
Practice address
7680 GODDARD ST, SUITE 100, COLORADO SPRINGS, CO 80920-8235
(719) 502-9779
(719) 418-6172
Mailing address
7680 GODDARD ST, SUITE 100, COLORADO SPRINGS, CO 80920-8235
(719) 502-9779
(719) 418-6172
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
43176
CO
Other
Enumeration date
03/06/2017
Last updated
03/06/2017
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