Integrative Health Practices, LLC
Family Medicine in Ellicott City, MD. Organization (NPI-2).
NPI number1033634530
StatusActive
Last updated in NPPESApr 24, 2023
Details
- NPI
- 1033634530
- Entity type
- Organization (NPI-2)
- Legal business name
- Integrative Health Practices, LLC
- Organization subpart
- No
- Enumeration date
- Aug 7, 2017
- Certification date
- Apr 24, 2023
- Last updated
- Apr 24, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
9501 Old Annapolis Rd Ste 205Ellicott City, MD 21042-6336
Phone 410-715-5256
Mailing address
9501 Old Annapolis Rd Ste 205Ellicott City, MD 21042-6336
Phone 410-648-2555 · Fax 443-681-1018
Authorized official
William Rollow
Owner
4107155256
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