Provider Demographics
NPI:1740520808
Name:INTEGRATIVE MEDICAL SOLUTIONS PLLC
Entity type:Organization
Organization Name:INTEGRATIVE MEDICAL SOLUTIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEZLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LINK
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:701-595-1535
Mailing Address - Street 1:311 N MANDAN ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-3859
Mailing Address - Country:US
Mailing Address - Phone:701-751-4464
Mailing Address - Fax:
Practice Address - Street 1:311 N MANDAN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-3859
Practice Address - Country:US
Practice Address - Phone:701-751-4464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND3781261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty