Healthcare Provider Details

I. General information

NPI: 1164432241
Provider Name (Legal Business Name): INTEGRATED MEDICAL CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 04/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3810 N GRANT AVE
LOVELAND CO
80538
US

IV. Provider business mailing address

PO BOX 271160
FT. COLLINS CO
80527
US

V. Phone/Fax

Practice location:
  • Phone: 970-221-9451
  • Fax: 877-535-9359
Mailing address:
  • Phone: 970-221-9451
  • Fax: 877-535-9359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DAVID FEEBACK, MBA
Title or Position: CFO
Credential: MBA
Phone: 970-221-9451