| Vitality Primary Care Llc | |
|
209 N Oak St Sallisaw OK 74955-4639 | |
| (918) 636-3930 | |
| (918) 636-3930 |
| Full Name | Vitality Primary Care Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 209 N Oak St, Sallisaw, Oklahoma |
| Authorized Official Name and Position | Niko Koliastasis (CEO) |
| Authorized Official Contact | 9186363930 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitality Primary Care Llc 209 N Oak St Sallisaw OK 74955-4639 Ph: (918) 636-3930 | Vitality Primary Care Llc 209 N Oak St Sallisaw OK 74955-4639 Ph: (918) 636-3930 |
| NPI Number | 1023546660 |
|---|---|
| Provider Enumeration Date | 05/26/2017 |
| Last Update Date | 05/26/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023546660 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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