Provider Demographics
NPI:1457702474
Name:INTERNATIONAL CENTERS FOR INTEGRATIVE HEALTH, LLC
Entity Type:Organization
Organization Name:INTERNATIONAL CENTERS FOR INTEGRATIVE HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:ALBRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DAAMLP, FIAMA
Authorized Official - Phone:360-499-1678
Mailing Address - Street 1:6 SHOREWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7752
Mailing Address - Country:US
Mailing Address - Phone:360-499-1678
Mailing Address - Fax:
Practice Address - Street 1:6 SHOREWOOD DR
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7752
Practice Address - Country:US
Practice Address - Phone:360-499-1678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5515111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty