| NPI | 1639576093 |
|---|---|
| Other Name | VITAL SPORTS AND WELLNESS |
| Entity Type | Organization |
| Authorized Contact | JENNIFER AMANDA JUSTICE Owner, Clinician 904-657-0089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
| 225700000X Massage Therapist | |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2024-01-31 |