Vital Life Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

VITAL LIFE PHYSICAL THERAPY

Practice address

2628 Bill Owens Pkwy
Longview, TX 75604-3001

Phone

(903) 241-1274

Fax

(903) 297-6453

NPI assigned

Jun 21, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Sarah Yvonne Rudolph, P.T.NPI 1255706594

Title

Owner

Phone

(903) 241-1274

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sarah Rudolph

  • Physical Therapist
  • Longview, TX
  • NPI 1255706594
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592697600000",
    "number": "1053937508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 DEERFIELD LAKE CIR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756057756",
            "telephone_number": "903-241-1274",
            "fax_number": "903-297-6453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2628 BILL OWENS PKWY",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756043001",
            "telephone_number": "903-241-1274",
            "fax_number": "903-297-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL LIFE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-21",
        "last_updated": "2020-06-21",
        "certification_date": "2020-06-21",
        "status": "A",
        "authorized_official_last_name": "RUDOLPH",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "YVONNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-241-1274",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerensa Lynn Vincent, RN
• Carmine M Vincifora, M.D.
• Elizabeth Ann Viramontes Sanchez, COTA
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• Visualeyes Optical, LLC (VisualEyes Optical)
• Jennifer Nguyen Vo
• Voncell Homecare Holdings LLC (Quality Homecare Sitter Service)
• Voyaage Practice Management
• Voyage Medical Solutions, LLC
• Brenda M Vozza, MD

• Physical Therapy Clinic/Center in Longview, TX
• Providers in Longview, TX by specialty
• Physical Therapy Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.