Organization
AGING VITALITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA WESTERGARD PTA (PHYSICAL THERAPIST ASSISTANT)
(720) 305-8214
Entity
Organization
Contact information
Practice address
472 MEETING ST STE C-140, CHARLESTON, SC 29403-4899
(720) 305-8214
Mailing address
472 MEETING ST STE C-140, CHARLESTON, SC 29403-4899
(720) 305-8214
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
10/10/2023
Last updated
08/26/2024
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