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INTEGRATED MEDICAL GROUP LLC NPI 1912578550


NPI Information

NPI: 1912578550
Provider Name: INTEGRATED MEDICAL GROUP LLC

Former Legal Business Name: DETRAY CHIROPRACTIC CENTER

Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
210 LATCHAW DR
DEFIANCE, OH
ZIP 43512
Phone: (419) 785-4215
Get Directions

INTEGRATED MEDICAL GROUP LLC is a general practice in Defiance, OH. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee INTEGRATED MEDICAL GROUP LLC NPI is 1912578550. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Detray Chiropractic Center.

The provider's business location address is:

210 LATCHAW DR
DEFIANCE, OH
ZIP 43512-315
Phone: (419) 785-4215
Fax: (419) 785-4274

The provider's authorized official is Megan Parks .
The authorized official title is Owner/doctor and has the following contact phone number (419) 785-4215.

The enumeration date for this NPI number is 7/6/2021 and was last updated on 9/13/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208D00000XGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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