MEDICARE: INTEGRATED HEALTH PROFESSIONALS, PC

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	225100000X	Physical Therapist	5501003699	MI

General Provider Information

NPI Number	:	1821121260
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED HEALTH PROFESSIONALS, PC

Provider Business Mailing Address
First Line	:	4478 DOWLING ST
Second Line	:
City	:	MONTAGUE
State	:	MI
Zip	:	49437-1201
Country	:	US
Telephone Number	:	231-894-4531
Fax Number	:	231-894-8158

Provider Business Practice Location Address
First Line	:	4478 DOWLING ST
Second Line	:
City	:	MONTAGUE
State	:	MI
Zip	:	49437-1201
Country	:	US
Telephone Number	:	231-894-4531
Fax Number	:	231-894-8158

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. CINDY L HODGES
Credential	:
Telephone Number	:	231-894-4531

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	08/22/2020

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