| NPI | 1205553120 |
|---|---|
| Doing Business As | VITALITY PAIN CARE |
| Entity Type | Organization |
| Authorized Contact | DAVID BOSOMWORTH Owner 502-290-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363LF0000X Nurse Practitioner, Family | |
| 207LP2900X Anesthesiology, Pain Medicine | |
| Enumeration Date | 2022-10-21 |
| Last Update Date | 2022-11-02 |