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NPI Code Detail

MEDICARE: INTEGRATED WELLNESS SYSTEMS

MEDICARE: INTEGRATED WELLNESS SYSTEMS
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
1174400000XSpecialist010116NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1106488GGOTHERNYMVP

General Provider Information

NPI Number : 1376588012
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTEGRATED WELLNESS SYSTEMS
Provider Business Mailing Address
First Line : 1687 ENGLISH RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14616-1609
Country : US
Telephone Number : 585-292-6428
Fax Number :
Provider Business Practice Location Address
First Line : 1687 ENGLISH RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14616-1609
Country : US
Telephone Number : 585-292-6428
Fax Number :
Authorized Official
Title or Position : MASSAGE THERAPIST
Name : CRAIG JOHN DANEHY
Credential : LMT
Telephone Number : 15852926428
Provider Enumeration Date : 06/17/2006
Last Update Date : 02/15/2012

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Directions to “INTEGRATED WELLNESS SYSTEMS ” Practice Location

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