Organization
VIBRANT LIVING WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEONA HARTER L.AC. (OWNER/ACUPUNCTURIST)
(912) 424-2871
Entity
Organization
Contact information
Practice address
180 W WALNUT ST, JESUP, GA 31545-1325
(912) 424-2871
(912) 307-3874
Mailing address
180 W WALNUT ST, JESUP, GA 31545-1325
(912) 424-2871
(912) 307-3874
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
294
GA
Other
Enumeration date
10/21/2016
Last updated
10/21/2016
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