Organization
VITAL GLOW- MEN'S AND WOMEN'S HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDACE DANBURY NP (OWNER)
(803) 470-6654
Entity
Organization
Contact information
Practice address
1494 LAKE MURRAY BLVD STE A, COLUMBIA, SC 29212-8697
(803) 470-6654
Mailing address
1494 LAKE MURRAY BLVD STE A, COLUMBIA, SC 29212-8697
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/01/2026
Last updated
04/08/2026
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