Most Relevant Information
Provider Data
| NPI Number: | 1003402207 |
| Provider Name: | VITALIS IM |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/12/2020 |
| Last Updated: | 06/07/2022 |
Provider Practice Location
210 COLLINGWOOD ST
ANN ARBOR
MI
481033813
Practice Location Phone/Fax
| Phone: | 2485818777 |
| Fax: |
Provider Mailing Location
108 S ADAMS ST UNIT 981076
YPSILANTI
MI
481987064
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |