| Vibrant Life Direct Care, Pllc | |
|
501 N Mustang Rd Ste B Mustang OK 73064-7044 | |
| (405) 708-3385 | |
| (800) 488-3294 |
| Full Name | Vibrant Life Direct Care, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 501 N Mustang Rd Ste B, Mustang, Oklahoma |
| Authorized Official Name and Position | Lydia J. Dennis (OWNER) |
| Authorized Official Contact | 4057083385 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vibrant Life Direct Care, Pllc 5225 E Tyler Dr Tuttle OK 73089-8305 Ph: (405) 708-3385 | Vibrant Life Direct Care, Pllc 501 N Mustang Rd Ste B Mustang OK 73064-7044 Ph: (405) 708-3385 |
| NPI Number | 1295365302 |
|---|---|
| Provider Enumeration Date | 01/17/2020 |
| Last Update Date | 01/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295365302 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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