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Organization
VITALITY MOBILE WOUND CARE LLC
Active
Organization
VITALITY MOBILE WOUND CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER LAMAR ETHRIDGE (CEO)
(903) 420-3446
Entity
Organization
Contact information
Practice address
6115 NEW COPELAND RD STE 640, TYLER, TX 75703-6368
(903) 420-3443
Mailing address
6115 NEW COPELAND RD STE 640, TYLER, TX 75703-6368
(903) 420-3443
(903) 630-8797
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
—
—
207Q00000X
Family Medicine Physician
—
—
208D00000X
General Practice Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/02/2025
Last updated
06/08/2026
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