Healthcare Provider Details

I. General information

NPI: 1487572632
Provider Name (Legal Business Name): VIBRANT REHAB SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6182 CREEKSIDE CT
GRAND BLANC MI
48439-7445
US

IV. Provider business mailing address

6182 CREEKSIDE CT
GRAND BLANC MI
48439-7445
US

V. Phone/Fax

Practice location:
  • Phone: 810-893-4440
  • Fax:
Mailing address:
  • Phone: 810-893-4440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. AMITKUMAR SHAH
Title or Position: PHYSICAL THERAPIST
Credential: RPT
Phone: 810-893-4440