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General NPI Number Information
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NPI Number | 1083236137
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Entity Type | Organization
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Legal Business Name | INTEGRITY WELLNESS CENTER
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Dates
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Enumeration Date | 05/12/2020
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Last Update Date | 03/28/2022
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Provider Practice Location Address
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Address Line | 2116 N CEDAR ST
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City | LUMBERTON
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State | NC
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Zip | 28358-3928
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Country | US
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Telephone | 910-674-3030
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Fax | 910-674-3051
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Provider Business Mailing Address
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Address Line | 2116 N CEDAR ST
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City | LUMBERTON
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State | NC
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Zip | 28358-3928
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Country | US
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Telephone | 910-674-3030
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Fax | 910-674-3051
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TRACEY MORENO- SILVA
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Credential |
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Telephone | 276-252-8811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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