=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487452017
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INTEGRITY HEALTH PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/07/2025
-----------------------------------------------------
Last Update Date | 03/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 119 N PAW PAW ST
-----------------------------------------------------
City | LAWRENCE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49064-9317
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 269-241-2220
-----------------------------------------------------
Fax | 269-219-2554
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 50973 COUNTY ROAD 681
-----------------------------------------------------
City | LAWRENCE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49064-9048
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-898-7718
-----------------------------------------------------
Fax | 260-210-2554
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRACTICE OWNER/ PROVIDER
-----------------------------------------------------
Name | MR. KEVIN FERRELL
-----------------------------------------------------
Credential | PA-C
-----------------------------------------------------
Telephone | 517-898-7718
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363AM0700X
-----------------------------------------------------
Taxonomy Name | Medical Physician Assistant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------