Organization
VITALITY FUNCTIONAL FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS SMITH (CO OWNER)
(918) 237-9889
Entity
Organization
Contact information
Practice address
2514 E 15TH ST STE A, TULSA, OK 74104-4655
(918) 237-9889
Mailing address
2514 E 15TH ST STE A, TULSA, OK 74104-4655
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/13/2024
Last updated
12/13/2024
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