National Provider Identifier Database

DESTINATION VITALITY LTD
Health Service


Contact Information

DESTINATION VITALITY LTD
310 SUNRISE AVE STE B
HONESDALE, PA18431-1032
Phone: 570-801-9488
Fax: 877-675-2576
Website:
Specialty Taxonomy Code
* Health Service 261QH0100X

* Indicates primary specialty

NPI Profile & details for DESTINATION VITALITY LTD

NPI Number 1689321382
Legal business name
LBN
DESTINATION VITALITY LTD
Authorized official DANA GALLIK - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 03/03/2022
Last updated 10/31/2024 - More than a year ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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