Provider Demographics
NPI:1770023749
Name:THE VITALITY CENTER LTD
Entity Type:Organization
Organization Name:THE VITALITY CENTER LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MS
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HOLLIS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, DIPLOM, MSTCM
Authorized Official - Phone:720-900-4372
Mailing Address - Street 1:128 W 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-5105
Mailing Address - Country:US
Mailing Address - Phone:720-900-4372
Mailing Address - Fax:
Practice Address - Street 1:128 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-5105
Practice Address - Country:US
Practice Address - Phone:720-900-4372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-24
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1730171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty