| Vitality Internal Medicine - Tempe Llc | |
|
4653 S Lakeshore Dr Ste 2 Tempe AZ 85282-7161 | |
| (480) 456-8981 | |
| Not Available |
| Full Name | Vitality Internal Medicine - Tempe Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 4653 S Lakeshore Dr Ste 2, Tempe, Arizona |
| Authorized Official Name and Position | Charles Benjamin Evans (OWNER) |
| Authorized Official Contact | 6027919112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitality Internal Medicine - Tempe Llc 5509 E Friess Dr Scottsdale AZ 85254-2966 Ph: () - | Vitality Internal Medicine - Tempe Llc 4653 S Lakeshore Dr Ste 2 Tempe AZ 85282-7161 Ph: (480) 456-8981 |
| NPI Number | 1669760203 |
|---|---|
| Provider Enumeration Date | 07/18/2011 |
| Last Update Date | 07/18/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669760203 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 37616 (Arizona) | Primary |
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