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Organization
TOTAL VITALITY HEALTH CARE LLC
Active
Organization
TOTAL VITALITY HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTINE KAY JOHNSON DC (MANAGER)
(239) 458-5747
Entity
Organization
Contact information
Practice address
2717 SANTA BARBARA BLVD, #8, CAPE CORAL, FL 33914-4432
(239) 458-5747
(239) 772-8747
Mailing address
2717 SANTA BARBARA BLVD, # 8, CAPE CORAL, FL 33914-4432
(239) 458-5747
(239) 772-8747
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH5548
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BA793
MEDICARE PTAN
FL
01
—
CH5548
STATE LICENSE
FL
Enumeration date
07/17/2008
Last updated
09/30/2011
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