MEDICARE: INTEGRATIVE CENTER FOR HEALTH

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	207Q00000X	Family Medicine Physician	32793	CO

General Provider Information

NPI Number	:	1932268141
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATIVE CENTER FOR HEALTH

Provider Business Mailing Address
First Line	:	315 CANYON AVE
Second Line	:	SUITE 3
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-2677
Country	:	US
Telephone Number	:	970-472-8008
Fax Number	:	970-416-7739

Provider Business Practice Location Address
First Line	:	315 CANYON AVE
Second Line	:	SUITE 3
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-2677
Country	:	US
Telephone Number	:	970-472-8008
Fax Number	:	970-416-7739

Authorized Official
Title or Position	:	OWNER
Name	:	NOLA MACDONALD
Credential	:	DO
Telephone Number	:	970-472-8008

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1043202385 — JACQUELINE C. FIELDS M.D.
Practice Location Address:

315 CANYON AVE , SUITE 1
FORT COLLINS, CO
80521-2677

Practice Phone: 970-472-6789
Practice Fax: 970-472-6799

1588651806 — MS. KATHERINE DUCHEN SMITH RN MS CPNP
Practice Location Address:

315 CANYON AVE , SUITE A
FORT COLLINS, CO
80521-2677

Practice Phone: 970-482-2136
Practice Fax:

1245256320 — NOLA ANNE MACDONALD D.O.
Practice Location Address:

315 CANYON AVE STE 3
FORT COLLINS, CO
80521-2677

Practice Phone: 970-472-8008
Practice Fax: 970-416-7739

1265450241 — PAUL WILSON SLAUGHTER LMFT
Practice Location Address:

315 CANYON AVE STE B
FORT COLLINS, CO
80521-2677

Practice Phone: 970-988-7042
Practice Fax:

1538274147 — LAURIE DENISE BYRNE P.T.
Practice Location Address:

315 CANYON AVE STE A
FORT COLLINS, CO
80521-2677

Practice Phone: 970-484-0571
Practice Fax:

1376602581 — HEALING GARDENS HEALTH CENTER
Practice Location Address:

315 CANYON AVE , SUITE1
FORT COLLINS, CO
80521-2677

Practice Phone: 970-472-6789
Practice Fax: 970-472-6799

Directions to “INTEGRATIVE CENTER FOR HEALTH ” Practice Location

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