Provider Demographics
NPI:1225692387
Name:INTEGRATIVE FAMILY CARE, PLLC
Entity Type:Organization
Organization Name:INTEGRATIVE FAMILY CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PA., OWNER, AUTHORIZED OFFICIAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUNN
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:586-709-5271
Mailing Address - Street 1:11256 ORCHARD HILL DR
Mailing Address - Street 2:
Mailing Address - City:BRUCE TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48065-4397
Mailing Address - Country:US
Mailing Address - Phone:586-709-5271
Mailing Address - Fax:
Practice Address - Street 1:52915 MOUND RD
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316-3266
Practice Address - Country:US
Practice Address - Phone:586-210-3200
Practice Address - Fax:586-210-3300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-24
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty