Organization
VITALITY MENS HEALTH AND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTY LONG (CREDENTIALING)
(901) 737-1992
Entity
Organization
Contact information
Practice address
6655 POPLAR AVE, SUITE 204, GERMANTOWN, TN 38138-3691
(901) 751-4477
(901) 751-4488
Mailing address
6655 POPLAR AVE, SUITE 204, GERMANTOWN, TN 38138-3691
(901) 751-4477
(901) 751-4488
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
46215
TN
Other
Enumeration date
09/21/2011
Last updated
01/19/2012
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