Provider Demographics
NPI:1760771406
Name:ROBINHOOD INTEGRATIVE HEALTH, PLLC
Entity Type:Organization
Organization Name:ROBINHOOD INTEGRATIVE HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:LANTELME
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-972-0784
Mailing Address - Street 1:3288 ROBINHOOD3288
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106
Mailing Address - Country:US
Mailing Address - Phone:336-768-3335
Mailing Address - Fax:336-768-4171
Practice Address - Street 1:3288 ROBINHOOD RD
Practice Address - Street 2:SUITE202
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-5464
Practice Address - Country:US
Practice Address - Phone:336-768-3335
Practice Address - Fax:336-768-4171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-04
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9601654261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care