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Organization
VITAL THERAPEUTICS INC
Active
Organization
VITAL THERAPEUTICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NATHANIEL VIZCAYNO PT (OWNER)
(847) 409-6643
Entity
Organization
Contact information
Practice address
34121 N US 45, SUITE 101, GRAYSLAKE, IL 60030
(847) 231-0174
(224) 252-2088
Mailing address
34121 N US 45, SUITE 101, GRAYSLAKE, IL 60030
(847) 231-0174
(224) 252-2088
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-011571
IL
Other
Enumeration date
03/11/2016
Last updated
03/11/2016
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