Organization
VITALITY INTERNAL MEDICINE - PHOENIX PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES B EVANS II MD (OWNER)
(602) 791-9112
Entity
Organization
Contact information
Practice address
4643 N 12TH ST, STE 101, PHOENIX, AZ 85014-4006
(602) 626-8986
Mailing address
8776 E SHEA BLVD, STE B3A-129, SCOTTSDALE, AZ 85260-6629
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
37616
AZ
Other
Enumeration date
04/21/2016
Last updated
04/21/2016
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