Provider Demographics
NPI:1689041899
Name:INTEGRATIVE CONSULTING LLC
Entity Type:Organization
Organization Name:INTEGRATIVE CONSULTING LLC
Other - Org Name:SISKIYOU PAIN CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:GRANER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:541-708-1595
Mailing Address - Street 1:PO BOX 1003
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-0034
Mailing Address - Country:US
Mailing Address - Phone:775-250-8110
Mailing Address - Fax:541-482-0964
Practice Address - Street 1:730 BIDDLE RD STE A
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6116
Practice Address - Country:US
Practice Address - Phone:541-708-1595
Practice Address - Fax:541-833-5008
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTEGRATIVE CONSULTING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-24
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty