# VIVERANT INTEGRATIVE CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Viverant Integrative Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255943767
- **Authorized official:** JO LEIGH HOLLAND (OWNER)
- **Authorized official phone:** (812) 255-1699

## Contact information

- **Practice address:** 335 SPRING ST STE B, JEFFERSONVILLE, IN 47130-4480
- **Practice address phone:** (812) 255-1699
- **Mailing address:** 300 SPRING ST STE 3B, JEFFERSONVILLE, IN 47130-3498
- **Mailing address phone:** (812) 255-1699

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QI0500X | Infusion Therapy Clinic/Center | — | NULL | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |

## Other

- **Enumeration date:** 08/18/2020
- **Last updated:** 04/05/2024