Organization
PHOENIX VITALITY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE LYNN RODRIGUEZ CNP (NURSE PRACTITIONER)
(419) 957-0631
Entity
Organization
Contact information
Practice address
603 E MAIN ST, LEIPSIC, OH 45856-1438
(419) 957-9737
Mailing address
603 E MAIN ST, LEIPSIC, OH 45856-1438
(419) 957-9737
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
01/31/2026
Last updated
01/31/2026
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