Healthcare Provider Details

I. General information

NPI: 1861867780
Provider Name (Legal Business Name): INTEGRATED REHAB INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2015
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

958 S KENMORE DR
EVANSVILLE IN
47714-7513
US

IV. Provider business mailing address

PO BOX 3276
EVANSVILLE IN
47731-3276
US

V. Phone/Fax

Practice location:
  • Phone: 812-401-2140
  • Fax: 812-777-4501
Mailing address:
  • Phone: 812-473-0181
  • Fax: 812-492-6498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. ERIC LEE MITZ
Title or Position: OWNER/CHIROPRACTOR
Credential: DC
Phone: 812-401-2140