Provider Demographics
NPI:1104592799
Name:INTEGRATIVE WELLNESS PARTNERS, INC
Entity type:Organization
Organization Name:INTEGRATIVE WELLNESS PARTNERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:HURD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-830-0277
Mailing Address - Street 1:603 E COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:NC
Mailing Address - Zip Code:28398-2104
Mailing Address - Country:US
Mailing Address - Phone:910-659-1088
Mailing Address - Fax:888-446-3125
Practice Address - Street 1:801 TILGHMAN DR STE C
Practice Address - Street 2:
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-4958
Practice Address - Country:US
Practice Address - Phone:910-659-1088
Practice Address - Fax:888-446-3125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site