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Organization

VITAL HEALING FUNCTIONAL MEDICINE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
OLIVIA GORANS CNP (SOLE MEMBER)
(605) 472-0404
Entity
Organization

Contact information

Practice address
1760 CENTRE ST STE B, RAPID CITY, SD 57703-4035
(605) 872-0404
(605) 472-7304
Mailing address
1760 CENTRE ST STE B, RAPID CITY, SD 57703-4035
(605) 872-0404
(605) 472-7304

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary

Other

Enumeration date
01/27/2022
Last updated
10/25/2023
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