Healthcare Provider Details

I. General information

NPI: 1508571357
Provider Name (Legal Business Name): INTEGRATED MOBILE THERAPEUTICS (IMT)
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2023
Last Update Date: 01/17/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 CITY FARM DR
BATON ROUGE LA
70806-7500
US

IV. Provider business mailing address

1800 CITY FARM DR
BATON ROUGE LA
70806-7500
US

V. Phone/Fax

Practice location:
  • Phone: 225-288-2539
  • Fax:
Mailing address:
  • Phone: 225-288-2539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: ALEX GEORGE DALMAU
Title or Position: MANAGING PARTNER
Credential:
Phone: 225-288-2539