# VIBRANT HEALTH PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659720936
- **Authorized official:** DR. FATIMA VILICH MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (435) 782-9384

## Contact information

- **Practice address:** 1910 PROSPECTOR AVE SUITE 302, PARK CITY, UT 84060
- **Practice address phone:** (435) 604-0594
- **Practice address fax:** (847) 919-8661
- **Mailing address:** 12202 DEER MOUNTAIN BLVD, KAMAS, UT 84036
- **Mailing address phone:** (435) 604-0594
- **Mailing address fax:** (847) 919-8661

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 036097212 | IL | — |
| 207R00000X | Internal Medicine Physician | 10369621-1205 | UT | Yes |

## Other

- **Enumeration date:** 06/08/2016
- **Last updated:** 07/21/2022