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General NPI Number Information
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NPI Number | 1952520041
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Entity Type | Organization
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Legal Business Name | INTEGRATED HEALTHCARE OF WOODSTOCK
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3353 TRICKUM RD SUITE 201
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City | WOODSTOCK
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State | GA
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Zip | 30188-3686
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Country | US
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Telephone | 770-517-1456
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Fax | 678-238-0352
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Provider Business Mailing Address
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Address Line | 3353 TRICKUM RD SUITE 201
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City | WOODSTOCK
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State | GA
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Zip | 30188-3686
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Country | US
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Telephone | 770-517-1456
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Fax | 678-238-0352
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KRISTA STARR WILLIAMS
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Credential |
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Telephone | 770-517-1456
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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 | 6463
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 008738
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License Number State | GA
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