Organization
VITALITY MEDICAL DISPENSARY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL HANDFORD (DIRECTOR)
(803) 218-9886
Entity
Organization
Contact information
Practice address
103 SUM MOR DR, WEST COLUMBIA, SC 29169-4828
(803) 244-9212
Mailing address
PO BOX 1320, LEXINGTON, SC 29071-1320
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
12/16/2016
Last updated
12/16/2016
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