Provider Demographics
NPI:1043832306
Name:INTEGRAL HEALING & WELLNESS INC.
Entity type:Organization
Organization Name:INTEGRAL HEALING & WELLNESS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, PHD
Authorized Official - Phone:941-402-5827
Mailing Address - Street 1:PO BOX 15301
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34277-1301
Mailing Address - Country:US
Mailing Address - Phone:941-402-5827
Mailing Address - Fax:
Practice Address - Street 1:40 SARASOTA CENTER BLVD STE F103
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-9713
Practice Address - Country:US
Practice Address - Phone:941-479-9894
Practice Address - Fax:941-259-0184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-09
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy