Provider Demographics
NPI:1043278195
Name:INTEGRATIVE THERAPIES, INC.
Entity type:Organization
Organization Name:INTEGRATIVE THERAPIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:COFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-254-0910
Mailing Address - Street 1:4112 SPRING GARDEN ST STE A
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-1652
Mailing Address - Country:US
Mailing Address - Phone:336-294-0910
Mailing Address - Fax:336-218-0294
Practice Address - Street 1:4112 SPRING GARDEN ST STE A
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1652
Practice Address - Country:US
Practice Address - Phone:336-294-0910
Practice Address - Fax:336-218-0294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133VN1006X
NCNC1307225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, MetabolicGroup - Multi-Specialty