Provider Demographics
NPI:1922667310
Name:VITALTIY HOLISTIC WELLNESS LLC
Entity Type:Organization
Organization Name:VITALTIY HOLISTIC WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KATELYN
Authorized Official - Middle Name:MCFARLAND
Authorized Official - Last Name:MILES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:252-541-2035
Mailing Address - Street 1:700 GARYSBURG RD
Mailing Address - Street 2:
Mailing Address - City:GASTON
Mailing Address - State:NC
Mailing Address - Zip Code:27832-9655
Mailing Address - Country:US
Mailing Address - Phone:252-541-2035
Mailing Address - Fax:252-541-2789
Practice Address - Street 1:700 GARYSBURG RD
Practice Address - Street 2:
Practice Address - City:GASTON
Practice Address - State:NC
Practice Address - Zip Code:27832-9655
Practice Address - Country:US
Practice Address - Phone:252-541-2035
Practice Address - Fax:252-541-2789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-10
Last Update Date:2022-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty