| Integrative Functional Medicine Wellness | |
|
901 Brookside Dr Apt 105 Lansing MI 48917-8210 | |
| (786) 945-5440 | |
| Not Available |
| Full Name | Integrative Functional Medicine Wellness |
|---|---|
| Speciality | Family Medicine |
| Location | 901 Brookside Dr Apt 105, Lansing, Michigan |
| Authorized Official Name and Position | Luis Gaspar Maduro (OWNER) |
| Authorized Official Contact | 7869455440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrative Functional Medicine Wellness 901 Brookside Dr Apt 105 Lansing MI 48917-8210 Ph: (786) 945-5440 | Integrative Functional Medicine Wellness 901 Brookside Dr Apt 105 Lansing MI 48917-8210 Ph: (786) 945-5440 |
| NPI Number | 1831953496 |
|---|---|
| Provider Enumeration Date | 02/13/2024 |
| Last Update Date | 02/13/2024 |
| Certification Date | 02/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831953496 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
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