Provider Demographics
NPI:1538965751
Name:RENEWED VITALITY CENTER
Entity type:Organization
Organization Name:RENEWED VITALITY CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:MAY
Authorized Official - Last Name:HAMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-877-6328
Mailing Address - Street 1:312 W BUTLER AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-5112
Mailing Address - Country:US
Mailing Address - Phone:215-345-1445
Mailing Address - Fax:
Practice Address - Street 1:312 W BUTLER AVE
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:PA
Practice Address - Zip Code:18901-5112
Practice Address - Country:US
Practice Address - Phone:215-345-1445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-19
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty