Provider Demographics
NPI:1598270969
Name:INTEGRATION BODYWORK LLC
Entity Type:Organization
Organization Name:INTEGRATION BODYWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:HILLIARD
Authorized Official - Last Name:ROBISON
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:608-535-1154
Mailing Address - Street 1:715 HILL ST STE 250
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-3572
Mailing Address - Country:US
Mailing Address - Phone:608-535-1154
Mailing Address - Fax:
Practice Address - Street 1:715 HILL ST STE 250
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3572
Practice Address - Country:US
Practice Address - Phone:608-535-1154
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty