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General NPI Number Information
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NPI Number | 1548718703
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE HEALTH ASSOCIATES PLLC
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Dates
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Enumeration Date | 09/16/2016
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Last Update Date | 04/21/2017
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Provider Practice Location Address
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Address Line | 515 N HIGHLAND ST
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City | MEMPHIS
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State | TN
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Zip | 38122-4572
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Country | US
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Telephone | 901-244-7599
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Fax |
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Provider Business Mailing Address
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Address Line | 515 N HIGHLAND ST
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City | MEMPHIS
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State | TN
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Zip | 38122-4572
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Country | US
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Telephone | 901-244-7599
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMY LY
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Credential | M.D.
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Telephone | 256-335-5754
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD0000054532
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License Number State | TN
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