MEDICARE: VIBRANT HEALTH SOLUTIONS CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	202D00000X	Integrative Medicine Physician

General Provider Information

NPI Number	:	1730887134
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIBRANT HEALTH SOLUTIONS CENTER

Provider Business Mailing Address
First Line	:	4931 W 6TH ST STE 116
Second Line	:
City	:	LAWRENCE
State	:	KS
Zip	:	66049-4831
Country	:	US
Telephone Number	:	785-749-1300
Fax Number	:	785-749-4746

Provider Business Practice Location Address
First Line	:	4931 W 6TH ST STE 116
Second Line	:
City	:	LAWRENCE
State	:	KS
Zip	:	66049-4831
Country	:	US
Telephone Number	:	785-749-1300
Fax Number	:	785-749-4746

Authorized Official
Title or Position	:	OWNER
Name	:	CYNTHIA JOHNSON
Credential	:	PT
Telephone Number	:	785-749-1300

Provider Enumeration Date	:	02/16/2023
Last Update Date	:	12/03/2025

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