Healthcare Provider Details

I. General information

NPI: 1154863017
Provider Name (Legal Business Name): UTECH INTEGRATIVE HEALTH, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2016
Last Update Date: 12/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

629 WEST ST S SUITE 300
GRINNELL IA
50112-8103
US

IV. Provider business mailing address

629 WEST ST S SUITE 300
GRINNELL IA
50112-8103
US

V. Phone/Fax

Practice location:
  • Phone: 641-236-8000
  • Fax:
Mailing address:
  • Phone: 641-236-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: MRS. ALLISON NICOLE UTECH
Title or Position: OFFICE MANAGER
Credential:
Phone: 641-990-7306