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General NPI Number Information
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NPI Number | 1043278195
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE THERAPIES, INC.
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 4112 SPRING GARDEN ST STE A
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City | GREENSBORO
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State | NC
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Zip | 27407-1652
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Country | US
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Telephone | 336-294-0910
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Fax | 336-218-0294
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Provider Business Mailing Address
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Address Line | 4112 SPRING GARDEN ST STE A
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City | GREENSBORO
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State | NC
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Zip | 27407-1652
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Country | US
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Telephone | 336-294-0910
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Fax | 336-218-0294
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MRS. NANCY KIM COFFIN
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Credential |
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Telephone | 336-254-0910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1006X
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Taxonomy Name | Metabolic Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | NC1307
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License Number State | NC
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