Organization
VITAL ENERGY OCC THERAPY & WELLNESS CTR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HIMA N DALAL OCCUPATIONAL THERAPI (OWNER)
(803) 951-3200
Entity
Organization
Contact information
Practice address
1812 AUGUSTA HWY, STE L, LEXINGTON, SC 29072
(803) 359-1551
(803) 233-9201
Mailing address
121 CLEARVIEW DR, COLUMBIA, SC 29212
(803) 951-3200
(803) 951-0990
Taxonomy
Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
Primary
2626
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11485055
CAZH
SC
Enumeration date
05/19/2006
Last updated
04/20/2008
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