Organization
VITALITY MED LLC
Active
Other names
Vitality Med
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARNA MARIE REVLOCK APRN (OWNER)
(330) 936-6863
Entity
Organization
Contact information
Practice address
128 WERTZ AVE NW STE A, CANTON, OH 44708-4196
(330) 936-6863
Mailing address
2210 UNIVERSITY DR SE, MASSILLON, OH 44646-7443
(330) 936-6863
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
12/07/2021
Last updated
12/07/2021
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