Healthcare Provider Details

I. General information

NPI: 1326327479
Provider Name (Legal Business Name): SYNERGY INTEGRATIVE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2011
Last Update Date: 08/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 N MAIN ST SUITE 2B
DOYLESTOWN PA
18901-3729
US

IV. Provider business mailing address

263 N MAIN ST SUITE 2B
DOYLESTOWN PA
18901-3729
US

V. Phone/Fax

Practice location:
  • Phone: 215-230-7442
  • Fax:
Mailing address:
  • Phone: 215-230-7442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW014851
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: LISA B KEUTMAN
Title or Position: OWNER
Credential:
Phone: 215-230-7442