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General NPI Number Information
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NPI Number | 1790444941
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Entity Type | Organization
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Legal Business Name | INTEGRITY HEALTH AND WELLNESS LLC
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Dates
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Enumeration Date | 12/15/2021
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Last Update Date | 12/17/2021
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Provider Practice Location Address
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Address Line | 1680 MID VALLEY DR STE C
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City | DE PERE
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State | WI
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Zip | 54115-9517
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Country | US
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Telephone | 920-658-5040
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Fax | 920-658-5039
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Provider Business Mailing Address
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Address Line | 1680 MID VALLEY DR STE C
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City | DE PERE
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State | WI
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Zip | 54115-9517
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Country | US
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Telephone | 920-658-5040
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Fax | 920-658-5039
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. BRANDON DYRDAHL
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Credential | DC
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Telephone | 218-230-4998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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