Provider Demographics
NPI:1073915500
Name:INTEGRATED HEALTH SERVICES OF DOOR COUNTY INC.
Entity Type:Organization
Organization Name:INTEGRATED HEALTH SERVICES OF DOOR COUNTY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:920-366-9455
Mailing Address - Street 1:6214 STATE HIGHWAY 42
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR
Mailing Address - State:WI
Mailing Address - Zip Code:54209-9135
Mailing Address - Country:US
Mailing Address - Phone:920-256-2865
Mailing Address - Fax:
Practice Address - Street 1:6214 STATE HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:EGG HARBOR
Practice Address - State:WI
Practice Address - Zip Code:54209-9135
Practice Address - Country:US
Practice Address - Phone:920-256-2865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-16
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4387012111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty