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Organization
VIBRANT HEALTH CENTER, LLC
Active
Organization
VIBRANT HEALTH CENTER, LLC
Active
Other names
Marisa Mikals, DC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARISA ANN MIKALS D.C. (OWNER)
(770) 309-1816
Entity
Organization
Contact information
Practice address
3950 COBB PKWY NW, SUITE 401, ACWORTH, GA 30101-9532
(770) 974-5215
Mailing address
2406 OWENS LANDING WAY NW, KENNESAW, GA 30152-6551
(770) 309-1816
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
007163
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1871619007
NPI
GA
Enumeration date
08/29/2010
Last updated
08/29/2010
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