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Organization
VIBRANT CHIROPRACTIC P.A.
Active
Organization
VIBRANT CHIROPRACTIC P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THAD CHRISTOPHER BETZOLD (CO-OWNER)
(651) 207-4411
Entity
Organization
Contact information
Practice address
8519 EAGLE POINT BLVD STE 175, LAKE ELMO, MN 55042-8629
(651) 207-4411
Mailing address
8519 EAGLE POINT BLVD STE 175, LAKE ELMO, MN 55042-8629
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6027
MN
111N00000X
Chiropractor
6028
MN
Other
Enumeration date
01/21/2015
Last updated
01/21/2015
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