Healthcare Provider Details

I. General information

NPI: 1891988606
Provider Name (Legal Business Name): INTEGRATIVE WELLNESS ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2007
Last Update Date: 08/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10576 W ALAMEDA AVE SUITE 2
LAKEWOOD CO
80226-2600
US

IV. Provider business mailing address

10576 W ALAMEDA AVE SUITE 2
LAKEWOOD CO
80226-2600
US

V. Phone/Fax

Practice location:
  • Phone: 303-969-0884
  • Fax: 303-969-0019
Mailing address:
  • Phone: 303-969-0884
  • Fax: 303-969-0019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number3988
License Number StateCO

VIII. Authorized Official

Name: MARK S AKERS
Title or Position: PRESIDENT
Credential: D.C.
Phone: 303-969-0884