Organization
VITALITY M12 LLC
Active
Other names
Vitality MGM LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDRA STABILE (CONTROLLER)
(702) 240-8531
Entity
Organization
Contact information
Practice address
4650 ARVILLE ST STE F, LAS VEGAS, NV 89103-5325
(702) 240-8531
(702) 441-1765
Mailing address
4650 ARVILLE ST STE F, LAS VEGAS, NV 89103-5325
(702) 240-8531
(702) 441-1765
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/21/2020
Last updated
04/21/2020
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