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General NPI Number Information
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NPI Number | 1144576307
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE FAMILY MEDICINE, LLC
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Dates
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Enumeration Date | 07/25/2012
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Last Update Date | 07/25/2012
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Provider Practice Location Address
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Address Line | 10440 SHAKER DR STE 103&203
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City | COLUMBIA
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State | MD
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Zip | 21046-1200
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Country | US
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Telephone | 888-953-0005
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Fax | 301-302-0799
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Provider Business Mailing Address
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Address Line | 10440 SHAKER DR STE 103&203
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City | COLUMBIA
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State | MD
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Zip | 21046-1200
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Country | US
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Telephone | 888-953-0005
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Fax | 301-302-0799
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Authorized Official
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Title or Position | OWNER, DOCTOR
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Name | DR. JENNIFER RABENHORST
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Credential | MD, MAC, LAC
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Telephone | 888-953-0005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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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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