Organization
VITALITY HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY W BENNETT MD (OWNER PROVIDER)
(304) 617-1511
Entity
Organization
Contact information
Practice address
10557 W CARLTON BAY DR STE 106, GARDEN CITY, ID 83714-5200
(304) 617-1511
Mailing address
10557 W CARLTON BAY DR STE 106, GARDEN CITY, ID 83714-5200
(304) 617-1511
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
12/13/2023
Last updated
12/13/2023
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