Provider Demographics
NPI:1184331506
Name:VIBRANT CHIROPRACTIC LLC
Entity type:Organization
Organization Name:VIBRANT CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:JUNE
Authorized Official - Last Name:DEMPSEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:419-464-9211
Mailing Address - Street 1:5658 MAIN ST STE 107
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-1930
Mailing Address - Country:US
Mailing Address - Phone:419-464-9211
Mailing Address - Fax:
Practice Address - Street 1:5658 MAIN ST STE 107
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-1930
Practice Address - Country:US
Practice Address - Phone:517-416-5088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-04
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty