| NPI | 1366018848 |
|---|---|
| Doing Business As | VITALOGY SKINCARE |
| Entity Type | Organization |
| Authorized Contact | BRET S BLACKHART President 775-336-3624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| 207ND0900X Dermatology, Dermatopathology | |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2021-06-14 |