Internal Medicine And Vitality, Pllc | |
6505 Constitution Blvd Ste C Portage MI 49024-1605 | |
(269) 254-3319 | |
Not Available |
Full Name | Internal Medicine And Vitality, Pllc |
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Speciality | Internal Medicine |
Location | 6505 Constitution Blvd Ste C, Portage, Michigan |
Authorized Official Name and Position | Amanda R Henry (OWNER) |
Authorized Official Contact | 2697624120 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Internal Medicine And Vitality, Pllc 6505 Constitution Blvd Ste C Portage MI 49024-1605 Ph: (269) 762-4120 | Internal Medicine And Vitality, Pllc 6505 Constitution Blvd Ste C Portage MI 49024-1605 Ph: (269) 254-3319 |
NPI Number | 1073357737 |
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Provider Enumeration Date | 06/19/2024 |
Last Update Date | 11/04/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073357737 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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