Organization
VITAL WELL LLC
Active
Parent organization
VITAL WELL LLC
Other names
Vital Well
Organization subpart
Yes
Provider details
NPI number
Legal business name
VITAL WELL LLC
Authorized official
ELIZABETH VITALE RDN, CDCES (OWNER)
(808) 595-6237
Entity
Organization
Contact information
Practice address
3939 VESELICH AVE APT 302, LOS ANGELES, CA 90039-1485
(808) 595-6237
Mailing address
3939 VESELICH AVE APT 302, LOS ANGELES, CA 90039-1485
(808) 595-6237
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
10/12/2021
Last updated
10/12/2021
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