Vitality Medical, Llc | |
2060 Overland Ave Ste 1a Billings MT 59102-6439 | |
(406) 855-2422 | |
(406) 204-5595 |
Full Name | Vitality Medical, Llc |
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Speciality | General Practice |
Location | 2060 Overland Ave Ste 1a, Billings, Montana |
Authorized Official Name and Position | Melissa Lynn Fuller (OWNER) |
Authorized Official Contact | 4066710184 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Vitality Medical, Llc 2060 Overland Ave Ste 1a Billings MT 59102-6439 Ph: (406) 855-2422 | Vitality Medical, Llc 2060 Overland Ave Ste 1a Billings MT 59102-6439 Ph: (406) 855-2422 |
NPI Number | 1942891205 |
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Provider Enumeration Date | 01/29/2021 |
Last Update Date | 07/24/2024 |
Medicare PECOS PAC ID | 9537575147 |
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Medicare Enrollment ID | O20210305001587 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942891205 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Melissa L Fuller |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831329804 PECOS PAC ID: 2769537125 Enrollment ID: I20090908000679 |
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