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General NPI Number Information
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NPI Number | 1477090652
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Entity Type | Organization
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Legal Business Name | INTEGRIS AMBULATORY CARE CORPORATION
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Dates
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Enumeration Date | 01/25/2017
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 2203 S MAIN ST
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City | GROVE
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State | OK
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Zip | 74344-5329
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Country | US
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Telephone | 918-786-3797
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 843754
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City | KANSAS CITY
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State | MO
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Zip | 64184-3754
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Country | US
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Telephone | 405-252-8400
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Fax |
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Authorized Official
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Title or Position | TREASURER
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Name | MICHAEL L WEED
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Credential |
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Telephone | 405-951-2737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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