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General NPI Number Information
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NPI Number | 1164811428
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Entity Type | Organization
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Legal Business Name | THE INDEPENDENCE CENTER FOR HYPERBARICS AND WELLNESS
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Dates
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Enumeration Date | 01/09/2015
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Last Update Date | 01/09/2015
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Provider Practice Location Address
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Address Line | 14330 OAKHILL LANE SUITE 140
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City | HUNTERSVILLE
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State | NC
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Zip | 28078
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Country | US
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Telephone | 704-997-8146
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Fax | 704-997-8125
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Provider Business Mailing Address
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Address Line | 14330 OAKHILL LANE SUITE 140
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City | HUNTERSVILLE
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State | NC
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Zip | 28078
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Country | US
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Telephone | 704-997-8146
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Fax | 704-997-8125
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Authorized Official
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Title or Position | NATIONAL MEDICAL DIRECTOR
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Name | DR. MICHAEL PETERS
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Credential | MD
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Telephone | 843-222-1142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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