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Organization

VITAL HEALTH CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KEVIN WRAY (OWNER)
(623) 218-1515
Entity
Organization

Contact information

Practice address
7707 W DEER VALLEY RD STE 115, PEORIA, AZ 85382-2101
(623) 218-1515
(623) 399-9958
Mailing address
7707 W DEER VALLEY RD STE 115, PEORIA, AZ 85382-2101
(623) 218-1515
(623) 399-9958

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
2747
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2747
LICENSE
AZ
Enumeration date
05/18/2015
Last updated
05/18/2015
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