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Organization

VITALIMD, PC

Active
Other names
The Joy and Healing Practice, PC
Organization subpart
No

Provider details

NPI number
Authorized official
LISA MARIE TODD (OWNER)
(406) 595-0852
Entity
Organization

Contact information

Practice address
117 EAST OAK STREET, BOZEMAN, MT 59715
(406) 595-0852
Mailing address
117 EAST OAK STREET, BOZEMAN, MT 59715
(406) 595-0852
(406) 571-7955

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
11366
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8460164
MT
Enumeration date
09/07/2017
Last updated
07/03/2018
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