Provider Demographics
NPI:1699191791
Name:VITALITY THERAPY, LLC
Entity Type:Organization
Organization Name:VITALITY THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-533-4216
Mailing Address - Street 1:597 W SESAME DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8364
Mailing Address - Country:US
Mailing Address - Phone:956-533-4216
Mailing Address - Fax:
Practice Address - Street 1:597 W SESAME DR
Practice Address - Street 2:SUITE E
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8364
Practice Address - Country:US
Practice Address - Phone:956-533-4216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy