Organization
VIBRANT HEALTH PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FATIMA VILICH MD (MEDICAL DIRECTOR)
(435) 782-9384
Entity
Organization
Contact information
Practice address
1910 PROSPECTOR AVE SUITE 302, PARK CITY, UT 84060
(435) 604-0594
(847) 919-8661
Mailing address
12202 DEER MOUNTAIN BLVD, KAMAS, UT 84036
(435) 604-0594
(847) 919-8661
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036097212
IL
207R00000X
Internal Medicine Physician
Primary
10369621-1205
UT
Other
Enumeration date
06/08/2016
Last updated
07/21/2022
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