Healthcare Provider Details
I. General information
NPI: 1952590267
Provider Name (Legal Business Name): INTEGRATED HEALTH & WELLNESS CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/23/2007
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
211 WELSH POOL RD STE 100
EXTON PA
19341-1321
US
IV. Provider business mailing address
855 SPRINGDALE DR SUITE 120
EXTON PA
19341
US
V. Phone/Fax
- Phone: 610-524-9520
- Fax: 610-524-0133
- Phone: 610-524-9520
- Fax: 610-524-0133
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | DC004305L |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | DC007087L |
| License Number State | PA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | OS007850L |
| License Number State | PA |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | OS007810L |
| License Number State | PA |
VIII. Authorized Official
Name: DR.
SHARON
A
LEONARDO-BARONE
Title or Position: DR/OWNER
Credential:
Phone: 610-524-9520