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General NPI Number Information
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NPI Number | 1528846581
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE HEALTHCARE OF LOWER ALABAMA
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Dates
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Enumeration Date | 09/20/2023
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 28720 U.S. 98, SUITE 1
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City | DAPHNE
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State | AL
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Zip | 36526
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Country | US
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Telephone | 251-241-4346
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Fax | 251-241-4356
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Provider Business Mailing Address
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Address Line | 28720 U.S. 98, SUITE 1
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City | DAPHNE
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State | AL
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Zip | 36526
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Country | US
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Telephone | 251-241-4346
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Fax | 251-241-4356
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Authorized Official
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Title or Position | OWNER
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Name | TARA MCLELLAN
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Credential |
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Telephone | 617-838-1844
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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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