Provider Demographics
NPI:1205073541
Name:VIBRANTHEALTHCONSULTANTSLLC
Entity type:Organization
Organization Name:VIBRANTHEALTHCONSULTANTSLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHIAS
Authorized Official - Middle Name:FC
Authorized Official - Last Name:PUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MT, CMT
Authorized Official - Phone:415-721-7726
Mailing Address - Street 1:740 POINT SAN PEDRO RD
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-2533
Mailing Address - Country:US
Mailing Address - Phone:415-721-7726
Mailing Address - Fax:415-721-7726
Practice Address - Street 1:655 REDWOOD HWY FRONTAGE RD
Practice Address - Street 2:SUITE 160
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-3034
Practice Address - Country:US
Practice Address - Phone:415-721-7726
Practice Address - Fax:415-721-7726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-08
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172M00000XOther Service ProvidersMechanotherapistGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty