| Vitality Medical, Llc | |
|
2060 Overland Ave Ste 1a Billings MT 59102-6439 | |
| (406) 855-2422 | |
| (406) 204-5595 |
| Full Name | Vitality Medical, Llc |
|---|---|
| Speciality | General Practice |
| Location | 2060 Overland Ave Ste 1a, Billings, Montana |
| Authorized Official Name and Position | Melissa Lynn Fuller (OWNER) |
| Authorized Official Contact | 4066710184 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitality Medical, Llc 2060 Overland Ave Ste 1a Billings MT 59102-6439 Ph: (406) 855-2422 | Vitality Medical, Llc 2060 Overland Ave Ste 1a Billings MT 59102-6439 Ph: (406) 855-2422 |
| NPI Number | 1942891205 |
|---|---|
| Provider Enumeration Date | 01/29/2021 |
| Last Update Date | 12/19/2023 |
| Medicare PECOS PAC ID | 9537575147 |
|---|---|
| Medicare Enrollment ID | O20210305001587 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942891205 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Melissa L Fuller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831329804 PECOS PAC ID: 2769537125 Enrollment ID: I20090908000679 |
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