Provider Demographics
NPI:1932783743
Name:INTEGRATED HEALTHCARE AND INJURY CENTER
Entity Type:Organization
Organization Name:INTEGRATED HEALTHCARE AND INJURY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-457-0584
Mailing Address - Street 1:2896 CHAMBLEE TUCKER RD STE 4
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-4009
Mailing Address - Country:US
Mailing Address - Phone:770-457-0584
Mailing Address - Fax:
Practice Address - Street 1:2896 CHAMBLEE TUCKER RD STE 4
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-4009
Practice Address - Country:US
Practice Address - Phone:770-457-0584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty