Healthcare Provider Details

I. General information

NPI: 1750523916
Provider Name (Legal Business Name): INTEGRATIVE HOMEOPATHY, P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2009
Last Update Date: 04/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 W CAMELBACK RD AMERICAN MEDICAL COLLEGE OF HOMEOPATHY
PHOENIX AZ
85015-3466
US

IV. Provider business mailing address

2001 W CAMELBACK RD AMERICAN MEDICAL COLLEGE OF HOMEOPATHY
PHOENIX AZ
85015-3466
US

V. Phone/Fax

Practice location:
  • Phone: 602-347-7950
  • Fax:
Mailing address:
  • Phone: 602-347-7950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number20040743
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number4301028720
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number13927
License Number StateAZ

VIII. Authorized Official

Name: DR. MARY GRACE WARNER
Title or Position: PHYSICIAN/OWNER
Credential: M.D., M.D.(H)
Phone: 602-326-7471