Provider Demographics
NPI:1083236137
Name:INTEGRITY WELLNESS CENTER
Entity Type:Organization
Organization Name:INTEGRITY WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MORENO- SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-252-8811
Mailing Address - Street 1:2116 N CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-3928
Mailing Address - Country:US
Mailing Address - Phone:910-674-3030
Mailing Address - Fax:910-674-3051
Practice Address - Street 1:2116 N CEDAR ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-3928
Practice Address - Country:US
Practice Address - Phone:910-674-3030
Practice Address - Fax:910-674-3051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-12
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty