| Vibrant Life Health & Wellness | |
|
7633 E Brainerd Rd Ste 101 Chattanooga TN 37421-3290 | |
| (473) 763-7226 | |
| Not Available |
| Full Name | Vibrant Life Health & Wellness |
|---|---|
| Speciality | Physical Medicine & Rehabilitation |
| Location | 7633 E Brainerd Rd Ste 101, Chattanooga, Tennessee |
| Authorized Official Name and Position | Doug Stithem (OWNER) |
| Authorized Official Contact | 4237637226 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vibrant Life Health & Wellness 7633 E Brainerd Rd Ste 101 Chattanooga TN 37421-3290 Ph: () - | Vibrant Life Health & Wellness 7633 E Brainerd Rd Ste 101 Chattanooga TN 37421-3290 Ph: (473) 763-7226 |
| NPI Number | 1477062958 |
|---|---|
| Provider Enumeration Date | 09/27/2017 |
| Last Update Date | 03/10/2020 |
| Medicare PECOS PAC ID | 5193154508 |
|---|---|
| Medicare Enrollment ID | O20200625001218 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477062958 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | (* (Not Available)) | Primary |
| Provider Name | Karen C Beets |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457470015 PECOS PAC ID: 0345201653 Enrollment ID: I20041020000889 |
| Provider Name | Doug Eugene Stithem |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1548532773 PECOS PAC ID: 9638325764 Enrollment ID: I20120806000678 |
| Provider Name | Susanna Neely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225541279 PECOS PAC ID: 5799040697 Enrollment ID: I20180524000542 |
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