Organization
DESTINATION VITALITY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANA GALLIK CRNP (OWNER)
(570) 637-1028
Entity
Organization
Contact information
Practice address
310 SUNRISE AVE STE B, HONESDALE, PA 18431-1032
(570) 801-9488
(877) 675-2576
Mailing address
20 MY WAY LN, BEACH LAKE, PA 18405-3111
(570) 637-1028
(877) 675-2576
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
03/03/2022
Last updated
10/31/2024
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