Provider Demographics
NPI:1689099020
Name:VIBRANT THERAPY, INC
Entity Type:Organization
Organization Name:VIBRANT THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PADGETT
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:270-766-1055
Mailing Address - Street 1:1205 WOODLAND DR
Mailing Address - Street 2:SUITE B100
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2709
Mailing Address - Country:US
Mailing Address - Phone:270-766-1055
Mailing Address - Fax:270-766-1056
Practice Address - Street 1:1205 WOODLAND DR
Practice Address - Street 2:SUITE B100
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2709
Practice Address - Country:US
Practice Address - Phone:270-766-1055
Practice Address - Fax:270-766-1056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-21
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment