Organization
VITALITY PLUS UROLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL BENJAMIN DECKER MD (OPERATING MANAGER)
(870) 232-5215
Entity
Organization
Contact information
Practice address
140 HIGHWAY 201 N, MOUNTAIN HOME, AR 72653-3158
(870) 232-5215
(870) 232-5240
Mailing address
PO BOX 2443, MOUNTAIN HOME, AR 72654-2443
(870) 232-5215
(870) 232-5240
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
02/24/2023
Last updated
08/13/2024
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