Healthcare Provider Details

I. General information

NPI: 1467109207
Provider Name (Legal Business Name): POINTE INTEGRATIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2022
Last Update Date: 03/02/2022
Certification Date: 02/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17770 MACK AVE
GROSSE POINTE MI
48230-6233
US

IV. Provider business mailing address

17770 MACK AVE
GROSSE POINTE MI
48230-6233
US

V. Phone/Fax

Practice location:
  • Phone: 313-924-5514
  • Fax:
Mailing address:
  • Phone: 313-924-5514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA J BUCHANAN-NORTHUP
Title or Position: OWNER/ACUPUNCTUIRST
Credential:
Phone: 313-924-5514