Provider Demographics
NPI:1477960482
Name:INTERGRATED ALTERNATIVE PROFESSIONALS
Entity type:Organization
Organization Name:INTERGRATED ALTERNATIVE PROFESSIONALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:AUSTIN
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-774-6333
Mailing Address - Street 1:2501 S VOLUSIA AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-9134
Mailing Address - Country:US
Mailing Address - Phone:386-774-6333
Mailing Address - Fax:888-407-6152
Practice Address - Street 1:2501 S VOLUSIA AVE
Practice Address - Street 2:STE 200
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-9134
Practice Address - Country:US
Practice Address - Phone:386-774-6333
Practice Address - Fax:888-407-6152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-22
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAP544OtherACUPUNCTURE