Individual
CHLOE VITALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
SOUTHERN ILLINOIS UNIVERSITY 6 HAIRPIN DR, EDWARDSVILLE, IL 62026-0001
(618) 650-3956
Mailing address
518 GREENBRIAR DOWNS DR, SAINT PETERS, MO 63376-7730
(636) 293-2115
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/24/2023
Last updated
07/22/2024
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