Organization
VALLEY VITALITY WELLNESS LLC
Active
Other names
Valley Vitality Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
CHANNA RIST RN (OWNER)
(760) 893-9632
Entity
Organization
Contact information
Practice address
1640 E KINZI CIR APT 4, WASILLA, AK 99654-8379
(760) 893-9632
Mailing address
1640 E KINZI CIR APT 4, WASILLA, AK 99654-8379
(760) 893-9632
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
11/22/2023
Last updated
11/22/2023
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