Provider Demographics
NPI:1659868032
Name:VSI PROVIDERS PLLC
Entity Type:Organization
Organization Name:VSI PROVIDERS PLLC
Other - Org Name:VIVOS JOHNSTOWN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL BILLING SPECIALIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-932-6943
Mailing Address - Street 1:4795 LARIMER PKWY
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80534-9021
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4795 LARIMER PKWY
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:CO
Practice Address - Zip Code:80534-9021
Practice Address - Country:US
Practice Address - Phone:970-699-7194
Practice Address - Fax:970-744-4498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-20
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty