Provider Demographics
NPI:1972269678
Name:VITALEE PT
Entity Type:Organization
Organization Name:VITALEE PT
Other - Org Name:VITALEE PT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:PATTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-774-7391
Mailing Address - Street 1:31 HAMPDEN RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-2421
Mailing Address - Country:US
Mailing Address - Phone:828-774-7391
Mailing Address - Fax:
Practice Address - Street 1:12 OLD CHARLOTTE HWY STE 30
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-9420
Practice Address - Country:US
Practice Address - Phone:828-774-7391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-17
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty