Integrative Physical Medicine Of Lakeland LLC
Specialist in Lakeland, FL. Organization (NPI-2).
NPI number1669908836
StatusActive
Last updated in NPPESMay 10, 2017
Details
- NPI
- 1669908836
- Entity type
- Organization (NPI-2)
- Legal business name
- Integrative Physical Medicine Of Lakeland LLC
- Organization subpart
- No
- Enumeration date
- May 10, 2017
- Last updated
- May 10, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
Other names
- Integrative Physical Medicine (Doing Business As)
Practice location
1205 East Magnolia StSuite 105
Lakeland, FL 33801
Phone 863-272-7454 · Fax 863-272-7456
Mailing address
1205 East Magnolia StSuite 105
Lakeland, FL 33801
Phone 863-272-7454 · Fax 863-272-7456
Authorized official
Marc Ott
President
4079773434
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