Provider Demographics
NPI:1568134864
Name:INTEGRITY BACK AND BRAIN LLC
Entity Type:Organization
Organization Name:INTEGRITY BACK AND BRAIN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GRASSL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-348-7000
Mailing Address - Street 1:8849 PINE ISLAND CT S
Mailing Address - Street 2:
Mailing Address - City:MATTAWAN
Mailing Address - State:MI
Mailing Address - Zip Code:49071-9570
Mailing Address - Country:US
Mailing Address - Phone:269-348-7000
Mailing Address - Fax:
Practice Address - Street 1:8849 PINE ISLAND CT S
Practice Address - Street 2:
Practice Address - City:MATTAWAN
Practice Address - State:MI
Practice Address - Zip Code:49071-9570
Practice Address - Country:US
Practice Address - Phone:269-348-7000
Practice Address - Fax:269-924-0675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health