| Integrative Health Llc | |
|
10528 Coldwater Rd Fort Wayne IN 46845-1268 | |
| (260) 338-1700 | |
| Not Available |
| Full Name | Integrative Health Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 10528 Coldwater Rd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Daniel Miller (OWNER) |
| Authorized Official Contact | 2603381700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrative Health Llc 10528 Coldwater Rd Fort Wayne IN 46845-1268 Ph: () - | Integrative Health Llc 10528 Coldwater Rd Fort Wayne IN 46845-1268 Ph: (260) 338-1700 |
| NPI Number | 1821669854 |
|---|---|
| Provider Enumeration Date | 07/09/2021 |
| Last Update Date | 07/09/2021 |
| Medicare PECOS PAC ID | 7618373234 |
|---|---|
| Medicare Enrollment ID | O20210908000721 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821669854 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
| Provider Name | Tina J Hermes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083667778 PECOS PAC ID: 3779581962 Enrollment ID: I20061122000409 |
| Provider Name | Daniel Steven Miller |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1023121779 PECOS PAC ID: 6709977671 Enrollment ID: I20070807000245 |
| Provider Name | Jessica R Ramer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134553357 PECOS PAC ID: 3971524034 Enrollment ID: I20131112000747 |
| Provider Name | Dustin Ryan Diller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467816934 PECOS PAC ID: 8224327309 Enrollment ID: I20160512000896 |
| Provider Name | Dustin Dean Yoder |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1821620410 PECOS PAC ID: 4688096845 Enrollment ID: I20200617002317 |
| Provider Name | Asia Chiffon James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588350557 PECOS PAC ID: 0749645737 Enrollment ID: I20230426001486 |
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