# VITALITY HEALTH NETWORK LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962908558
- **Authorized official:** MS. LUCY MARTINEZ (OFFICE MANAGER)
- **Authorized official phone:** (843) 410-0330

## Contact information

- **Practice address:** 3100 DICK POND RD UNIT E, MYRTLE BEACH, SC 29588-7286
- **Practice address phone:** (843) 410-0330
- **Mailing address:** 3100 DICK POND RD UNIT E, MYRTLE BEACH, SC 29588-7286
- **Mailing address phone:** (843) 410-0330

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/03/2018
- **Last updated:** 04/03/2018