Provider Demographics
NPI:1982384335
Name:VITALITY PRIMARY CARE LLC
Entity Type:Organization
Organization Name:VITALITY PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF ACUPUNCTURE AND CHINESE M
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:DACM
Authorized Official - Phone:530-414-9813
Mailing Address - Street 1:10021 MARTIS VALLEY RD STE A
Mailing Address - Street 2:
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96161-2205
Mailing Address - Country:US
Mailing Address - Phone:530-414-9813
Mailing Address - Fax:
Practice Address - Street 1:10021 MARTIS VALLEY RD STE A
Practice Address - Street 2:
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161-2205
Practice Address - Country:US
Practice Address - Phone:530-414-9813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty