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General NPI Number Information
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NPI Number | 1548636616
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Entity Type | Organization
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Legal Business Name | AERETE INTEGRATIVE MEDICINE LLC
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Dates
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Enumeration Date | 08/12/2015
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 601 N SHORE DR STE 102
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130
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Country | US
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Telephone | 812-924-7884
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Fax | 812-924-7909
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Provider Business Mailing Address
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Address Line | 10908 KEENE RD
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City | LOUISVILLE
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State | KY
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Zip | 40241-4860
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Country | US
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Telephone | 812-924-7884
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Fax | 812-924-7909
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. LINDA MCCLAIN
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Credential | MD
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Telephone | 910-540-5612
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 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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