Organization
VITALITY HEALTH GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAY L HENDERSON (CEO)
(317) 652-2147
Entity
Organization
Contact information
Practice address
1702 W MICHIGAN ST, INDIANAPOLIS, IN 46222-3983
(317) 652-2147
Mailing address
1702 W MICHIGAN ST, INDIANAPOLIS, IN 46222-3983
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01029301A
IN
Other
Enumeration date
07/10/2009
Last updated
07/10/2009
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