Organization
VITAL HEALTH PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSLY ALEX CRNP (AUTHORIZED SIGNATORY)
(215) 738-2072
Entity
Organization
Contact information
Practice address
930 HENRIETTA AVE STE C, HUNTINGDON VALLEY, PA 19006-8523
(215) 663-9380
(215) 663-9383
Mailing address
293 PHEASANT DR, HUNTINGDON VALLEY, PA 19006-3036
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
08/06/2020
Last updated
09/09/2021
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