Healthcare Provider Details

I. General information

NPI: 1881093169
Provider Name (Legal Business Name): INTEGRATIVE HEALTH & INJURY CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2014
Last Update Date: 08/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 CESERY BLVD ROOM 6
JACKSONVILLE FL
32211-5605
US

IV. Provider business mailing address

835 CESERY BLVD ROOM 6
JACKSONVILLE FL
32211-5605
US

V. Phone/Fax

Practice location:
  • Phone: 904-745-0208
  • Fax:
Mailing address:
  • Phone: 904-534-5663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberARNP 770742
License Number StateFL

VIII. Authorized Official

Name: MS. DEBORAH MAE FRALICKER
Title or Position: PRESIDENT
Credential: ARNP
Phone: 904-534-5663