Provider Demographics
NPI:1275836017
Name:INTEGRATIVE WELLNESS GROUP LLC
Entity Type:Organization
Organization Name:INTEGRATIVE WELLNESS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-814-9262
Mailing Address - Street 1:340 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-2438
Mailing Address - Country:US
Mailing Address - Phone:303-814-9262
Mailing Address - Fax:303-814-9264
Practice Address - Street 1:340 3RD ST
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-2438
Practice Address - Country:US
Practice Address - Phone:303-814-9262
Practice Address - Fax:303-814-9264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-17
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6334111N00000X
CO4045111N00000X
COACU1610171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty