| Vital Personalized Healthcare, Llc | |
|
23 Plantation Park Dr Bldg 400 Bluffton SC 29910 | |
| (803) 460-5699 | |
| Not Available |
| Full Name | Vital Personalized Healthcare, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 23 Plantation Park Dr, Bluffton, South Carolina |
| Authorized Official Name and Position | Christopher W. Leblanc (OWNER/PHYSICIAN) |
| Authorized Official Contact | 8438155566 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital Personalized Healthcare, Llc 23 Plantation Park Dr Ste B Bluffton SC 29910-6038 Ph: (803) 460-5699 | Vital Personalized Healthcare, Llc 23 Plantation Park Dr Bldg 400 Bluffton SC 29910 Ph: (803) 460-5699 |
| NPI Number | 1245772672 |
|---|---|
| Provider Enumeration Date | 11/16/2016 |
| Last Update Date | 05/22/2018 |
| Medicare PECOS PAC ID | 0042591349 |
|---|---|
| Medicare Enrollment ID | O20161228001583 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245772672 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MDO 985 DO (South Carolina) | Primary |
| Provider Name | Christopher William Leblanc |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205875853 PECOS PAC ID: 1557374824 Enrollment ID: I20060803000395 |
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