VITAL LIVING WELLSPA - NPI 1790151157 - Registered Nurse in Fort Wayne, IN

Q: What is Vital Living Therapeutic Massage, LLC's specialty?

The primary specialty registered for this NPI is Registered Nurse, specializing in Nurse Massage Therapist (NMT), with taxonomy code 163WM1400X.

On this page

About Vital Living Wellspa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VITAL LIVING WELLSPA (NPI 1790151157) is a healthcare organization registered as a nurse massage therapist (nmt) in Fort Wayne, Indiana and active in the NPI registry since August 2015. The organization lists Janet Carroll, Owner, as its authorized official.

NPPES Registry Identity

NPI1790151157

Entity TypeOrganization

Primary Taxonomy163WM1400X

Legal Business NameVITAL LIVING THERAPEUTIC MASSAGE, LLC

Location Address5111 N BEND DRFort Wayne, IN 46804-1753

Mailing Address5111 N Bend DrFort Wayne, IN 46804-1753 · (260) 436-8807 · Fax (260) 436-2767

Phone(260) 436-8807

Fax(260) 436-2767

Organization SubpartNo

Authorized OfficialJanet CarrollOwner · (260) 436-8807

Enumeration DateAugust 19, 2015

✔ NPI 1790151157 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRegistered Nurse · Nurse Massage Therapist (NMT)Nursing Service Providers

Taxonomy Code163WM1400X

License✔ Licensed in IN · 28057959A

Also ListedMassage TherapistTaxonomy 225700000X · License MT20901877 (IN)

5111 N BEND DR, Fort Wayne, IN 46804

Open in Google Maps ↗

Other Names 1

Doing Business AsVital Living Wellspa

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TERRIE LYNNE HAYES

Massage Therapist