Provider Demographics
NPI:1487420444
Name:VYTAL HEALTH SOLUTIONS LLC
Entity type:Organization
Organization Name:VYTAL HEALTH SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HITSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:918-671-1908
Mailing Address - Street 1:90 OAKMONT RD
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH PORT
Mailing Address - State:MA
Mailing Address - Zip Code:02675-1666
Mailing Address - Country:US
Mailing Address - Phone:918-671-1908
Mailing Address - Fax:508-888-9100
Practice Address - Street 1:383 S ORLEANS RD
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:MA
Practice Address - Zip Code:02631-2879
Practice Address - Country:US
Practice Address - Phone:508-240-3500
Practice Address - Fax:508-888-9100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty