Provider Demographics
NPI:1578037206
Name:VIBRANT HEALTH CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:VIBRANT HEALTH CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BORBIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:603-856-7790
Mailing Address - Street 1:16 CHASE ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5727
Mailing Address - Country:US
Mailing Address - Phone:603-568-9256
Mailing Address - Fax:
Practice Address - Street 1:783 ROUTE 3A
Practice Address - Street 2:
Practice Address - City:BOW
Practice Address - State:NH
Practice Address - Zip Code:03304-4045
Practice Address - Country:US
Practice Address - Phone:603-856-7790
Practice Address - Fax:603-856-7894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty