Provider Demographics
NPI:1669002416
Name:VIBE WELLNESS LLC
Entity Type:Organization
Organization Name:VIBE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HANRAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-891-5711
Mailing Address - Street 1:3970 S ARCO CIR
Mailing Address - Street 2:
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-1727
Mailing Address - Country:US
Mailing Address - Phone:801-891-5711
Mailing Address - Fax:
Practice Address - Street 1:2263 E MURRAY HOLLADAY RD
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117-5392
Practice Address - Country:US
Practice Address - Phone:801-891-5711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-21
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty