Provider Demographics
NPI:1558502377
Name:VIBRANCE CHIROPRACTIC & WELLNESS CENTER, LTD
Entity Type:Organization
Organization Name:VIBRANCE CHIROPRACTIC & WELLNESS CENTER, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSKALIK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-658-6066
Mailing Address - Street 1:PO BOX 453
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:IL
Mailing Address - Zip Code:60013-3205
Mailing Address - Country:US
Mailing Address - Phone:847-658-6066
Mailing Address - Fax:866-837-6099
Practice Address - Street 1:716 LAUREL LANE
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:IL
Practice Address - Zip Code:60013-3205
Practice Address - Country:US
Practice Address - Phone:847-658-6066
Practice Address - Fax:866-837-6099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-09
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty