Provider Demographics
NPI:1841449725
Name:INTEGRATIVE PATHWAYS TO HEALTH & HEALING LLC
Entity type:Organization
Organization Name:INTEGRATIVE PATHWAYS TO HEALTH & HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SHERIDAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:717-943-7611
Mailing Address - Street 1:P.O. BOX 710
Mailing Address - Street 2:
Mailing Address - City:ENOLA
Mailing Address - State:PA
Mailing Address - Zip Code:17025-0710
Mailing Address - Country:US
Mailing Address - Phone:717-943-7611
Mailing Address - Fax:
Practice Address - Street 1:2311 FAIRFIELD ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-6310
Practice Address - Country:US
Practice Address - Phone:717-943-7611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-16
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA134009Medicare PIN