Provider Demographics
NPI:1023665676
Name:VITALITY RESTORED CHIROPRACTIC AND WELLNESS CENTER
Entity type:Organization
Organization Name:VITALITY RESTORED CHIROPRACTIC AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:PARTRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:725-735-6910
Mailing Address - Street 1:1742 W HORIZON RIDGE PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-4833
Mailing Address - Country:US
Mailing Address - Phone:725-735-6910
Mailing Address - Fax:725-735-6914
Practice Address - Street 1:1742 W HORIZON RIDGE PKWY STE 110
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-4833
Practice Address - Country:US
Practice Address - Phone:725-735-6910
Practice Address - Fax:725-735-6914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-19
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center