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Healthcare Organization Stored source record

VIBRANTHEALTHCONSULTANTSLLC

655 REDWOOD HWY FRONTAGE RD, SUITE 160, MILL VALLEY, CA, 949413034

atlas:atm_npi_1205073541

Block 2006Block Group 2Census Tract 1262Marin CountyCaliforniaUnited States

What is stored

phone
415-721-7726
status
A
address
655 REDWOOD HWY FRONTAGE RD, SUITE 160, MILL VALLEY, CA, 949413034
fax
415-721-7726
npi
1205073541
taxonomy
Mechanotherapist
other names
[]
last updated
2014-09-26
taxonomy code
172M00000X
all taxonomies
["Nutritionist","Specialist","Massage Therapist","Mechanotherapist"]
enumeration date
2009-01-08
enumeration type
NPI-2
practice locations
0
authorized official
MATTHIAS PUTZ
organizational subpart
NO

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{
  "fax": "415-721-7726",
  "npi": "1205073541",
  "phone": "415-721-7726",
  "status": "A",
  "address": "655 REDWOOD HWY FRONTAGE RD, SUITE 160, MILL VALLEY, CA, 949413034",
  "license": null,
  "taxonomy": "Mechanotherapist",
  "other_names": [],
  "last_updated": "2014-09-26",
  "license_state": null,
  "taxonomy_code": "172M00000X",
  "all_taxonomies": [
    "Nutritionist",
    "Specialist",
    "Massage Therapist",
    "Mechanotherapist"
  ],
  "enumeration_date": "2009-01-08",
  "enumeration_type": "NPI-2",
  "practice_locations": 0,
  "authorized_official": "MATTHIAS PUTZ",
  "organizational_subpart": "NO"
}