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Organization

VITAL NEUROLOGY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KISHORE RASAMALLU (MD/OWNER)
(210) 379-8553
Entity
Organization

Contact information

Practice address
1165 SANDERS RD, CUMMING, GA 30041-5965
(802) 735-0001
Mailing address
410 PEACHTREE PKWY STE 4245, CUMMING, GA 30041-7407
(802) 735-0001

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
363L00000X
Nurse Practitioner

Other

Enumeration date
07/29/2025
Last updated
07/29/2025
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