Healthcare Provider Details

I. General information

NPI: 1720251242
Provider Name (Legal Business Name): INTEGRATIVE HEALTH SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2008
Last Update Date: 04/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

354 W CHICAGO ST
COLDWATER MI
49036-1855
US

IV. Provider business mailing address

354 W CHICAGO ST
COLDWATER MI
49036-1855
US

V. Phone/Fax

Practice location:
  • Phone: 517-278-9869
  • Fax: 517-278-4573
Mailing address:
  • Phone: 517-278-9869
  • Fax: 517-278-4573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301004642
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number2301004642
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License Number2301004642
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number2301004642
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code111NT0100X
TaxonomyThermography Chiropractor
License Number2301004642
License Number StateMI
# 6
Primary TaxonomyN
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License Number2301004642
License Number StateMI
# 7
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number2301004642
License Number StateMI
# 8
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number2301004642
License Number StateMI

VIII. Authorized Official

Name: DR. MARK D LIROT
Title or Position: PRESIDENT
Credential: DC
Phone: 517-278-9869