| Vibrant Life Chiropractic Llc | |
|
2863 N Friendship Rd Paducah KY 42001-8605 | |
| (270) 558-3119 | |
| Not Available |
| Full Name | Vibrant Life Chiropractic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2863 N Friendship Rd, Paducah, Kentucky |
| Authorized Official Name and Position | Lauradell Hogancamp Wilson (DOCTOR OF CHIROPRACTIC) |
| Authorized Official Contact | 2705625623 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vibrant Life Chiropractic Llc 2863 N Friendship Rd Paducah KY 42001-8605 Ph: (270) 558-3119 | Vibrant Life Chiropractic Llc 2863 N Friendship Rd Paducah KY 42001-8605 Ph: (270) 558-3119 |
| NPI Number | 1285083741 |
|---|---|
| Provider Enumeration Date | 06/06/2016 |
| Last Update Date | 09/06/2016 |
| Medicare PECOS PAC ID | 7416243258 |
|---|---|
| Medicare Enrollment ID | O20160906000181 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285083741 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 5407 (Kentucky) | Primary |
| Provider Name | Lauradell H Wilson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1346675337 PECOS PAC ID: 7911131370 Enrollment ID: I20131018000323 |
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