Healthcare Provider Details
I. General information
NPI: 1669190963
Provider Name (Legal Business Name): INTEGRATED HEALTHCARE PARTNERS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/22/2022
Last Update Date: 12/27/2023
Certification Date: 12/27/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7710 W LOWER BUCKEYE RD STE 115
PHOENIX AZ
85043-3439
US
IV. Provider business mailing address
13221 W PALO VERDE DR
LITCHFIELD PARK AZ
85340-8356
US
V. Phone/Fax
- Phone: 623-776-2225
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2081N0008X |
| Taxonomy | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMBER
LINDNER
Title or Position: BILLER
Credential:
Phone: 623-776-2225