Organization
VITALITY MEDICAL LLC
Active
Other names
Vitality Medical
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA BRONSON (OWNER)
(616) 204-0074
Entity
Organization
Contact information
Practice address
110 HOLT DR, MADISON, IN 47250-3873
(812) 265-6141
Mailing address
110 HOLT DR, MADISON, IN 47250-3873
(812) 265-6141
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
07/16/2022
Last updated
07/16/2022
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