Provider Demographics
NPI:1376716472
Name:INNOVATIVE WOMENS HEALTH, PLC
Entity Type:Organization
Organization Name:INNOVATIVE WOMENS HEALTH, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:TERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-969-8828
Mailing Address - Street 1:363 FREMONT ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-3389
Mailing Address - Country:US
Mailing Address - Phone:269-969-8828
Mailing Address - Fax:269-969-8827
Practice Address - Street 1:363 FREMONT ST
Practice Address - Street 2:SUITE 302
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3389
Practice Address - Country:US
Practice Address - Phone:269-969-8828
Practice Address - Fax:269-969-8827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty