Provider Demographics
NPI:1841734456
Name:INTEGRATIVE FAMILY MEDICINE, LLC
Entity type:Organization
Organization Name:INTEGRATIVE FAMILY MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:D
Authorized Official - Last Name:BOYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-483-8140
Mailing Address - Street 1:426 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:AL
Mailing Address - Zip Code:35550-6000
Mailing Address - Country:US
Mailing Address - Phone:205-483-8140
Mailing Address - Fax:205-483-8144
Practice Address - Street 1:426 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:AL
Practice Address - Zip Code:35550-6000
Practice Address - Country:US
Practice Address - Phone:205-483-8140
Practice Address - Fax:205-483-8144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-15
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty