Provider Demographics
NPI:1629630025
Name:DELAWARE INTEGRATIVE HEALTHCARE OF MILFORD, LLC
Entity Type:Organization
Organization Name:DELAWARE INTEGRATIVE HEALTHCARE OF MILFORD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:HARMON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:240-298-4700
Mailing Address - Street 1:421 E. MAIN ST.
Mailing Address - Street 2:STE 6
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-1463
Mailing Address - Country:US
Mailing Address - Phone:302-376-5830
Mailing Address - Fax:302-376-6517
Practice Address - Street 1:600 N. DUPONT BLVD
Practice Address - Street 2:STE 686
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1002
Practice Address - Country:US
Practice Address - Phone:302-376-5830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-05
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty