Organization
VITALITY MEDICAL SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILLIAN D CANNON PA (MEDICAL DIRECTOR)
(307) 689-1831
Entity
Organization
Contact information
Practice address
2241 FARNUM ST STE 105, CASPER, WY 82609-4108
(307) 689-1831
Mailing address
2241 FARNUM ST STE 105, CASPER, WY 82609-4108
(307) 689-1831
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/16/2024
Last updated
09/16/2024
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