Provider Demographics
NPI:1538435136
Name:NATURAL VIBRANT HEALTH, PLLC
Entity type:Organization
Organization Name:NATURAL VIBRANT HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-834-2888
Mailing Address - Street 1:2501 BENTLEY DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-4113
Mailing Address - Country:US
Mailing Address - Phone:972-834-2888
Mailing Address - Fax:817-719-9342
Practice Address - Street 1:3330 MATLOCK RD
Practice Address - Street 2:SUITE 206
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-2921
Practice Address - Country:US
Practice Address - Phone:817-465-2225
Practice Address - Fax:817-719-9342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-28
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9678111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty