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Organization

VITALITY ANTI-AGING CENTER AND MED SPA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GRACE MCLAURIN PA (OWNER)
(828) 322-1498
Entity
Organization

Contact information

Practice address
74 8TH ST SE, SUITE 101, HICKORY, NC 28602-1130
(828) 322-1498
(828) 322-2835
Mailing address
74 8TH STREET SE, SUITE 101, HICKORY, NC 28602-4942
(828) 322-1498
(828) 322-2835

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary

Other

Enumeration date
03/25/2007
Last updated
11/24/2014
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