OrganizationActive
Vital Life Physical Therapy
NPI 1053937508 · Physical Therapy Clinic/Center · Longview, TX
Provider details
- NPI number
- 1053937508
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Sarah Rudolph, Owner(903) 241-1274
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(64/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2628 Bill Owens Pkwy
Longview, TX 75604-3001
Phone: (903) 241-1274
Fax: (903) 297-6453
Street-level locationGet directions
Mailing address
331 Deerfield Lake Cir
Longview, TX 75605-7756
Registry dates
- Enumerated
- 2020-06-21
- Last updated
- 2020-06-21
- Certified
- 2020-06-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.