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General NPI Number Information
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NPI Number | 1962698381
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Entity Type | Organization
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Legal Business Name | INTEGRATED HEALTH CENTER LLC
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 11/04/2014
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Provider Practice Location Address
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Address Line | 226 E BURWELL AVE
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City | LOUDONVILLE
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State | OH
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Zip | 44842-9504
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Country | US
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Telephone | 419-994-5222
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Fax | 419-994-4443
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Provider Business Mailing Address
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Address Line | PO BOX 715
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City | DANVILLE
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State | OH
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Zip | 43014-0715
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Country | US
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Telephone | 740-599-7562
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Fax | 740-599-6166
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. NATHAN JEREMIAH STINEMETZ
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Credential | DC
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Telephone | 419-994-5222
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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 | DC3106
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License Number State | OH
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