| Vibrant Life Direct Care, Pllc | |
|
2618 E Highway 37 Ste 100 Tuttle OK 73089-8479 | |
| (405) 376-1381 | |
| (800) 488-3294 |
| Full Name | Vibrant Life Direct Care, Pllc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 2618 E Highway 37 Ste 100, Tuttle, Oklahoma |
| Authorized Official Name and Position | Lydia Jemison 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 2618 E Highway 37 Ste 100 Tuttle OK 73089-8479 Ph: (405) 376-1381 | Vibrant Life Direct Care, Pllc 2618 E Highway 37 Ste 100 Tuttle OK 73089-8479 Ph: (405) 376-1381 |
| NPI Number | 1730880212 |
|---|---|
| Provider Enumeration Date | 03/13/2023 |
| Last Update Date | 03/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730880212 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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