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General NPI Number Information
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NPI Number | 1821289372
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE MEDICAL CENTERS OF OHIO INC
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Dates
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Enumeration Date | 08/08/2007
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Last Update Date | 08/08/2007
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Provider Practice Location Address
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Address Line | 148 W MAIN STREET
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City | CORTLAND
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State | OH
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Zip | 44410-1432
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Country | US
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Telephone | 330-638-7310
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Fax | 330-638-7257
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Provider Business Mailing Address
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Address Line | 148 W MAIN STREET
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City | CORTLAND
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State | OH
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Zip | 44410-1432
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Country | US
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Telephone | 330-638-7310
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Fax | 330-638-7257
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. THOMAS PAUL MONTGOMERY
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Credential | DC
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Telephone | 330-638-7310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number | 812
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License Number State | OH
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