Provider Demographics
NPI:1942582176
Name:INTEGRATED MEDICAL ACUPUNCTURE
Entity Type:Organization
Organization Name:INTEGRATED MEDICAL ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NEILSON
Authorized Official - Middle Name:MURRAY
Authorized Official - Last Name:MATHEWS
Authorized Official - Suffix:IV
Authorized Official - Credentials:MD
Authorized Official - Phone:610-584-3169
Mailing Address - Street 1:140 CLEMENS RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438-2010
Mailing Address - Country:US
Mailing Address - Phone:610-584-3169
Mailing Address - Fax:
Practice Address - Street 1:140 CLEMENS RD
Practice Address - Street 2:SUITE 104
Practice Address - City:HARLEYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19438-2010
Practice Address - Country:US
Practice Address - Phone:610-584-3169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-14
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPAK000161171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty