# VITAL HEALTH ALLIANCE GROUP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** VITAL HEALTH ALLIANCE GROUP
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1902764053
- **Legal business name:** VITAL HEALTH ALLIANCE GROUP
- **Authorized official:** MRS. SERENA BROOKE WILSON APRN (OWNER)
- **Authorized official phone:** (918) 961-1658

## Contact information

- **Practice address:** 2104 S MAIN ST, GROVE, OK 74344-5356
- **Practice address phone:** (918) 999-9339
- **Practice address fax:** (918) 238-9990
- **Mailing address:** 828 A ST NW, MIAMI, OK 74354-4605
- **Mailing address phone:** (918) 999-9339
- **Mailing address fax:** (918) 238-9990

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/15/2026
- **Last updated:** 01/15/2026