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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