Provider Demographics
NPI:1760214084
Name:VITALITY INTEGRATIVE HEALTH, P.A., LLC
Entity type:Organization
Organization Name:VITALITY INTEGRATIVE HEALTH, P.A., LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMURRY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:805-279-4787
Mailing Address - Street 1:401 JUSTISON ST APT 206
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-5291
Mailing Address - Country:US
Mailing Address - Phone:805-279-4787
Mailing Address - Fax:
Practice Address - Street 1:319 PRICE AVE
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-1917
Practice Address - Country:US
Practice Address - Phone:302-300-9468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-15
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty