Healthcare Provider Details

I. General information

NPI: 1184538308
Provider Name (Legal Business Name): VIBRANT FAMILY HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 S GARRISON AVE
CARTHAGE MO
64836-1749
US

IV. Provider business mailing address

433 S GARRISON AVE
CARTHAGE MO
64836-1749
US

V. Phone/Fax

Practice location:
  • Phone: 417-359-8646
  • Fax: 417-359-8344
Mailing address:
  • Phone: 417-359-8646
  • Fax: 417-359-8344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: BRITTANY MAGGARD
Title or Position: OFFICE MANAGER
Credential:
Phone: 417-359-8646