Provider Demographics
NPI:1578901518
Name:BLUE RIDGE INTEGRATIVE HEALTH, PC
Entity Type:Organization
Organization Name:BLUE RIDGE INTEGRATIVE HEALTH, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOILIEN
Authorized Official - Suffix:
Authorized Official - Credentials:D,O,
Authorized Official - Phone:828-265-8668
Mailing Address - Street 1:610 STATE FARM RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-4738
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:610 STATE FARM RD
Practice Address - Street 2:SUITE B
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4738
Practice Address - Country:US
Practice Address - Phone:828-265-8668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9801675208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty