# VIBRANT LIFE HEALTH COACH LLC

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

## Provider details

- **NPI number:** 1972149631
- **Authorized official:** TRACEY ROUNDS (OWNER)
- **Authorized official phone:** (315) 777-2649

## Contact information

- **Practice address:** 861 WATER ST, WATERTOWN, NY 13601-2115
- **Practice address phone:** (315) 777-2649
- **Mailing address:** 861 WATER ST, WATERTOWN, NY 13601-2115

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174H00000X | Health Educator | — | NULL | Yes |
| 174H00000X | Health Educator | — | — | Yes |

## Other

- **Enumeration date:** 11/18/2019
- **Last updated:** 11/18/2019