Organization Name: | VITALITY GROUP OF WNY |
NPI Number: | 1154750321 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | FRED GRANT MORSE (PRESIDENT) |
Mailing Address: | 3670 Mckinley Pkwy Massage Envy Blasdell |
State: | NY US |
Postal Code: | 142192696 |
Phone Number: | 7168223689 |
Fax Number: | |
NPI Enumeration Date: | 11/07/2013 |
NPI Last Update Date: | 11/07/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 21MA1407640 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |