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Organization

VITALITY HEALTHCARE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CLAYTON GIBSON III DC, PH.D. (CEO)
(404) 477-2300
Entity
Organization

Contact information

Practice address
554 NORTH AVE NW STE C, ATLANTA, GA 30318-6909
(404) 477-2300
(404) 477-2301
Mailing address
33 BLUE RIDGE TRL, POWDER SPRINGS, GA 30127-6877
(678) 467-0587

Taxonomy

Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
111NS0005X
Sports Physician Chiropractor
Primary
171100000X
Acupuncturist
208000000X
Pediatrics Physician

Other

Enumeration date
10/04/2021
Last updated
10/25/2021
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