Vibrant Chiropractic P.a.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6027 Issued in MN

Legal business name

VIBRANT CHIROPRACTIC P.A.

Practice address

8519 Eagle Point Blvd Ste 175
Lake Elmo, MN 55042-8629

Phone

(651) 207-4411

NPI assigned

Jan 21, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Thad Christopher Betzold

Title

Co-Owner

Phone

(651) 207-4411

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421798400000",
    "number": "1609265156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8519 EAGLE POINT BLVD STE 175",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550428629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8519 EAGLE POINT BLVD STE 175",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550428629",
            "telephone_number": "651-207-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIBRANT CHIROPRACTIC P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-21",
        "last_updated": "2015-01-21",
        "status": "A",
        "authorized_official_last_name": "BETZOLD",
        "authorized_official_first_name": "THAD",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "651-207-4411"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6027",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6028",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valley Ridge Dental, LLC
• Lindsey Van de Laarschot
• Richy Fuechee Vang Sr., BA
• Zoualia Vang, DNP, APNP, NP-C
• Venthouse Counseling
• Monica Arlene Villa, PMHNP-BC, APRN, CNP
• Viverant, LLC
• Eleni Voltidi
• Anne Elizabeth Voss, MPT
• Sarah M Wagner, M.A., L.M.F.T

• Chiropractor in Lake Elmo, MN
• Providers in Lake Elmo, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.