| Integrative Health Pc | |
|
2935 N Ashley St Suite 114 Valdosta GA 31602-1777 | |
| (229) 219-1831 | |
| Not Available |
| Full Name | Integrative Health Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2935 N Ashley St, Valdosta, Georgia |
| Authorized Official Name and Position | Tiffany Michelle Kumpel (PRESIDENT) |
| Authorized Official Contact | 2293339632 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrative Health Pc 2935 N Ashley St Ste 114 Valdosta GA 31602-1788 Ph: (229) 219-1831 | Integrative Health Pc 2935 N Ashley St Suite 114 Valdosta GA 31602-1777 Ph: (229) 219-1831 |
| NPI Number | 1962780171 |
|---|---|
| Provider Enumeration Date | 07/22/2011 |
| Last Update Date | 02/29/2012 |
| Medicare PECOS PAC ID | 7719159441 |
|---|---|
| Medicare Enrollment ID | O20110930000418 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962780171 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 54448 (Georgia) | Primary |
| Provider Name | Tiffany M Delice |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619976891 PECOS PAC ID: 9234106048 Enrollment ID: I20040913000224 |
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